Jerry Bears

Name of Bear  1.___________  2._____________  3. ______________*

Quantity ______                         ________               ________

$8.00 ea. ___________

Shipping:

$3.00        ___________

Total:       ____________

Name: _______________________

Address:  _____________________

Phone: _______________________

E-Mail _______________________ (Opt.)

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

* For more than 3 bears, print out a seperate form or use back.

Thank you for helping us to help the whales and dolphins!