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Required fields are marked with a (*)

1. *Your Full Name


2. *Telephone w/area code


3. *Date(s) Requested


4. *Would you like this in your room for arrival or shipped to your home?

Deliver to my room
Ship to my home ($10.00) delivery time approx 1 week


5. Shipping address:


6. *Email Address


7. Would you like to add our infamous Crowne Pointe Duckie for $5.00 each?


8. Special Notes:



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