Print this order form and send it via snail mail to the address below.

Yes! I would like a Kookopolo and Kookopolomana pattern of my of my very own!

Yes! I would like ____________Kookopolo and Kookopolomana patterns for my friends and I to enjoy!

So I am sending $8.00 (American) to Li Hertzi,

300 Carlsbad Village Drive
#108a-272
Carlsbad, CA 92008

lihertzi@lihertzidesign.com


Name _________________________________________________

Address _______________________________________________

Address Two___________________________________________

City, State, Zip _________________________________________

No, but Yes to the list!