Number of Bag, Hat, or Scarf  #____

         Quantity _______

Color if choice ________

Name ________________________________

Address ______________________________

Phone ________________________________

E-mail ________________________________Optional

Check ____

Credit Card# ___________________________ Exp. Date _______

____Visa ____Mastercard ____Discover Card

You may E-mail this information to: dolphin@bluedolphin.org

Or Call Toll Free:   (888) -6WHALES

Or Phone:        (831) 761-1477

Or Print out Form & Mail To:

Blue Dolphin Alliance

P O Box 312

Watsonville, CA 95077

Merchandise Amount _______________                 

                 Postage:   ___________5.00

                 Total       _______________

                 Tax Included