Make Check Payable To:
Wayne Caldwell
P.O.Box 951, Lewisville, Tx 75067

Name ____________________________________
Address __________________________________
City __________________ State _____ Zip ______

ItemPriceQuanityTotal
Coronet Head Large Cent$9.95__________
Braided Hair Large Cent$9.95__________
FE/Indian Penny$9.95__________
Two Cent Piece$9.95__________
Shield Nickel$9.95__________
"V" Nickel$9.95__________
Buffalo Nickel$9.95__________
Mercury Dime$9.95__________
Standing Liberty Quarter$9.95__________
Barber Half$9.95__________
Walking Liberty Half$9.95__________
Franklin Half$9.95__________
Morgan Dollar$9.95__________
Trade Dollar$9.95__________
Peace Dollar$9.95__________
2 1/2 Dollar Indian Gold$9.95__________
5 Dollar Indian Gold$9.95__________
SubTotal ______
U.S. Postage _$2.95
Total ______

Please Print and mail with order