"El Tejano" Order Form

Number Ordered:	#________
Amount Enclosed:	$________

(Please Print or Type)

Purchaser's Name:

Mailing Address:

City: State: Zip:

Phone:

Fax:

Email:

PRINT AND COMPLETE THIS FORM AND MAIL IT WITH YOUR PAYMENT TO:

The Tejano Monument, Inc.
P.O. Box 2948
McAllen, Texas 78502-2948

THANK YOU FOR YOUR SUPPORT!