Tick Kit Order Form                                 
                                              Quantity                            
  Price Schedule                     Ordered                
Tick Kits               $4.00  Each     ________   X  $4.00  =  _________
                                                                                            Total    
Your name and/or Organization _________________________________________
Address _________________________
City __________________ St. _______________ Zip _________

                                                        Make check payable to Lyme Association
                                                                     Mail to: Lyme Association of KC
Other options ?  Larger Quantities ?                          Tick removal Kit                        
Describe your needs                                                   P.O.Box 25853
______________________________                        Overland Park, KS 66225
Send your option request to Lymekc@yahoo.com
______________________________________________________________
______________________________________________________________
______________________________________________________________