QUALITY THIN SECTIONS                   DATE________________

                                                                                     9835 E CELESTE DR

                                                                                  TUCSON ARIZONA 85730                         __________________

                                                                                          (520) 884-9935                                             ORDER NUMBER

NAME:_______________________________          COMPANY:_________________________________________

ADDRESS:___________________________________________________________________________________

CITY:__________________________________      STATE:_________          ZIP:__________________

E-MAIL:________________________________________ phone_____________________________

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               please make precut chips approx. 1/2"    www.qualitythinsections.com