245 SW 132nd Terrace
Newberry, FL 32669
Tel (352) 331-2595
245 SW 132nd Terrace
Newberry, FL 32669
Tel (352) 331-2595
Please print out this order form and mail with payment to the address above.
| Customer: | Ship to: (if different from customer address) | |
| Name:____________________________ | Name:____________________________ | |
| Address:__________________________ | Address:__________________________ | |
| _________________________________ | _________________________________ | |
| City: _____________________________ | City: _____________________________ | |
| State: ______________ Zip: __________ | State: ______________ Zip: __________ | |
| Telephone: ________________________ | Telephone: ________________________
|
| Qty. | Catalog No. | Size 18 or 24 count |
Description | Unit Price | Total | |
|---|---|---|---|---|---|---|
| Please make checks or money orders
payable to: Janet Patacca
Please remit all funds in US dollars and allow 2-3 weeks for delivery. Shipping within the US is $5.00. Please call for overseas charges. |
Subtotal | |||||
| Sales Tax (Florida deliveries add 6.25%) |
||||||
| Shipping Charges |
$5.00 |
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| Total Enclosed | ||||||
