Printable Order Form

Printable Order Form
Billing First Name: ___________________ M.I.____ Last Name:_________________	Shipping First Name:_________________ M.I.____ Last Name:_________________
Mailing Address: ______________________________	Shipping Address: ___________________________
City:_____________________________	City:_____________________________
State:________ ZIP/Postal Code:____________	State:_______ZIP/Postal Code:__________
Phone: ( )____________	Phone : ( )_____________

Quantity:	Description:	Item Price: $	Item Total: $
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Notes:		SUBTOTAL:
		+ TAX:
		+ S & H:
		TOTAL:
Check / Money Order ( ) Credit Card: ( ) Visa ( ) Master Card -Card Number: ______________________________ Ex. _______ --Card Holders Name: ___________________________________ Signature: _____________________________________________

Products produced under USDA inspection. Interstate shipments available. Contact us about for foreign shipment restrictions.