Going Home Order Form

Please fill in the appropriate information and send form along with a check or money order payable to "Jonathan D. Shea" (in U.S. dollars) to:

        L&LP c/o J. Shea
        8 Lyle Rd
        New Britain CT  06053-2104
 

DELIVER TO (please fill in your complete address below):

Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

City. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Postal Code . . . . . . . . . . . . . . . . . . . . . . . . . . .  . . . . . . . . . . . . . . . . . . . .

E-mail address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

(The e-mail address is only to allow us to contact you if there is any problem or delay. It will not be given to anyone else.)