Geronimos Coin Order Form

Price: $10.00, includes shipping

Please enclose check made out to Geronimos Coin and send to:

Geronimos Coin

PO Box 97155

Tacoma, WA 98497-0155

YOUR ORDER INFORMATION:

Number of coins ___ X $10.00 = Total amount enclosed: $_________

NOTE: Overseas orders, please adjust total to cover the extra postage to your location. (Does not apply to APO addresses.) Thank you!

Address (print neatly, this will be your mailing label):

Name:

Street:

City/State:

Zip: