Mail to :
Alan Powell
C/O Pig Sticker Bait Company
801 Chicory Lane
Aurora, MO 65605
                                                   
                              
Name:                                 
                              
                 
  Quantity                 Jigs Style                  Weight                  Head Color                Skirt Color         Per phone call quoted price                extended price

1_________________________________________________________________________________________________________________________
                                     

2_________________________________________________________________________________________________________________________
                                     

3_________________________________________________________________________________________________________________________
                                    

4_________________________________________________________________________________________________________________________
                                   

5_________________________________________________________________________________________________________________________                   
                                           

6_________________________________________________________________________________________________________________________                   
                                            

7_________________________________________________________________________________________________________________________                   
                                           

8_________________________________________________________________________________________________________________________                   
                                          

9__________________________________________________________________________________________________________________________                 
                                             

10________________________________________________________________________________________________________________________                   
                                            

11________________________________________________________________________________________________________________________                   
                                            

12________________________________________________________________________________________________________________________                   
                                           

13________________________________________________________________________________________________________________________                   
                                            

14________________________________________________________________________________________________________________________                   
                                          

15________________________________________________________________________________________________________________________                   
                                           

16_________________________________________________________________________________________________________________________                 
                                            

17_________________________________________________________________________________________________________________________                 
                                            

18_________________________________________________________________________________________________________________________                 
                                            

19_________________________________________________________________________________________________________________________

                                  
20_________________________________________________________________________________________________________________________                 
                                             
Make checks payable to Alan Powell
Make checks payable to Alan Powell