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4.
2.
Quantity
Cost
Subtotal
Tax
TOTAL
3.
Name:
Address:
Phone:
E-mail:
Karla Humphrey Pendleton
ADDRESS: PO Box 665, Silverton, CO, 81433 USA
PHONE: (877)880-2347
EMAIL: karlapendleton@juno.com
To Order: Fill out this form, press the submit button and we'll get back to you as soon as possible
Tax Number:
if applicable
9.
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12.
Shipping will be charged according to current US Postal Rates
Please contact us for international rates and shipping charges
8.00% Colorado
Residents Only
If you run out of room on this form please submit a second form
1.
not including
shipping charge
City/State/Zip:
Item
ADDRESS: PO Box 665, Silverton, CO, 81433 USAPHONE: (877)880-2347EMAIL: karlapendleton@juno.com
