Printable Order Form

Your Name: ______________________________________

Mailing Address:______________________________________________

City:______________________ State:_________ Zip:________________

Phone Number:______________________ Email:_________________

Item:____________________ Qty:_____ x Price:_______ = ___________

Item:____________________ Qty:_____ x Price:_______ = ___________

Item:____________________ Qty:_____ x Price:_______ = ___________

Item:____________________ Qty:_____ x Price:_______ = ___________

Item:____________________ Qty:_____ x Price:_______ = ___________

Item:____________________ Qty:_____ x Price:_______ = ___________

Item:____________________ Qty:_____ x Price:_______ = ___________

Item:____________________ Qty:_____ x Price:_______ = ___________

Item:____________________ Qty:_____ x Price:_______ = ___________

Item:____________________ Qty:_____ x Price:_______ = ___________

Subtotal:____________


Subtotal of $4.50 or less: Shipping and Handling is $2.50
Subtotal of $4.51 - $20.00: Shipping and Handling is $6.95
Subtotal of $20.01 and up: Shipping and Handling is $9.95

Shipping and Handling:__________

Ohio Residents add 7.25% sales tax on Subtotal + Shipping and Handling:__________

Total:______________

Make Check or Money order payable to:
Luella Caudill
30600 Cadiz Dennison RD
Uhrichsville, OH 44683