Paul Browning
  2819 Thrush Dr.
  Clarksville, TN  37040

Delbert Anderson
16140 Creamery Hill Rd.
Laurelville, OH   43135
---------------------------------------- below is record for shipper -------------------------------------
 Attach USPS receipt/tracking to this form

  Delbert Anderson
 16140 Creamery Hill Rd.
 Laurelville, OH   43135

Node Number

Email address
Cell Phone       740-648-9844
Land Line

  Application Process Guide: for temporary office use only                                                Date completed
1. PayPal transaction
2. Application/shipping label

3. Updated financial submittal/sales record

4. Email address added to MADAR List

5. Welcome letter to purchaser with set-up instructions

6. Announcent to MADAR List

7. Date shipped