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| Email address (so we can notify you when your package is shipped): ___________________________ | |
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ARTOMAT PATCH How many are you ordering? _________ Please enclose $5 per patch. Shipping is included. | |
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Make checks or money orders payable to: Clark Whittington, Artists in Cellophane Mail this form along with a check or money order to: Clark Whittington, Artists in Cellophane 5000 Rushland Drive Winston-Salem NC 27104  
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