Order Form

1) Please print out this order form and fill in all required information.

2) Make Check/Money Order Payable to John Coppa and mail to:

Smart Casino Gambling

P.O. Box 5472

Wakefield, R.I. 02880

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Any Three Cards

1)____________2)____________3)____________

Price-------------------------------$7.95

S/H ---------------------------------2.50

Total -------------------------------$10.45

R.I. residents add 7% sales tax (R.I.total $11)

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3) Please Ship My Order To:

Name_______________________________

Address______________________________

City_______________State_____Zip_______

Phone / E-Mail ________________________

Please tell us how you found John Coppa's web site?

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