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Please
print this form. 
Person
Ordering:
Name:
_____________________________________
Address: ___________________________________
City:
_______________________________
State:
___________ Zip Code: ______________
email
address: _______________________
Shipping
Address (if different)
Name:
______________________________________
Address:
____________________________________
City:
_______________________________
State:
____________ Zip Code: ______________
No. of Items/Sets
Paperweight:
___ @ $45.00 each $_______
Trinket
Box: ___ @ $37.50 each
$_______
Set of
2 Whiskey Glasses: __ @ $55.00 each $_______
Subtotal
$_______
Shipping and Handling Charge =
$_______
First Item:
$9.00
Second Item: add $4.00
Third Item: add $4.00
Total = $_______
Please make your check made out to the Cassidy
Clan, and mail to Cassidy Clan, P.O. Box 482,
Patterson, NY 12563. Your items will arrive
3 to 4 weeks after your
check has cleared.

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Thank
you for your purchase. Your generous support
of the Cassidy Clan by purchasing items
from our Gift Shop assists us in producing
the clan newsletter and hosting this website.
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