Mail Payment To: (check or money order) Costa Enterprises 810 Warren Road Cockeysville, Maryland 21030 Fax: 410-667-0166 Home/ Work: 410-667-3626
A PRINTABLE ORDER FORM For The Commemorative Quarters
Name: * Address: *
City: *
State: *Zip: *
Phone number: *
Fax number:
NOTE: You can type in your order on this page then Print it or Print out this page then write in your order. This page has all the Commemorative Quarters along with the other Gold on Silver Coins.
All Gold Commemorative Quarters
"1999" Year end set (contains all 5): $29.95ea.
Delaware: $8.95ea Pennsylvania: $8.95ea New Jersey: $8.95ea
Georgia: $5.95 Connecticut: $5.95
Massachusetts: $5.95 Maryland: $5.95 S. Carolina: $5.95
The Two-Tone (gold on Silver) Commemorative Quarters
"1999" Year end set (contains all 5): $77.95ea.
Delaware: $18.95ea Pennsylvania: $18.95ea New Jersey: $18.95ea
Georgia: $14.95 Connecticut: $14.95
Massachusetts: $14.95 Maryland: $14.95 S. Carolina: $14.95
Ordering numbers and prices for the other
Gold on Silver Collectibe coins
#6: $13 #8: $13 #15: $8 #18: $13 #20: $13
#22: $13 #24: $13 #30: $21 #32: $21 #36: $14
#63: $35 #65: $37 #67: $35 #70: $15 #72: $15
#74: $15 #75: $15
Please ADD $3.00 for S/H TOTAL AMOUNT: * Any Comments? Thank You
Please ADD $3.00 for S/H
TOTAL AMOUNT: *