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Canned Product Order Form All products are available by the Single Can, in a four can Gift Box or by the Case. Single Can Order (Minimum order four (4) single cans)
Single Can Order Total: _______________ (24 - 8 ounce cans)
Case Order Total: _______________
Date Ordered: __________________________________ Paid: Yes or No Date Called into UPS: ____________________________ |
Shipping will be done via UPS Ground at the following rates to any State in the USA (with the exception of Alaska and Hawaii). Please call for rates for Alaska & Hawaii or to other locations.
Ordered By: Name: ______________________________ Street Address: ____________________________ City: _________________________ State: ____ Zip: _________ Ship to (if different than Ordered by): Name: ______________________________ Street Address: ___________________________ City: ________________________ State: ____ Zip: _________ Please include your personal check, money order or credit card information with your order. You will be billed for your order (including Shipping and Handling) at the time of shipment. Circle One: Visa MasterCard Discover AmExpress Credit Card#:______________________________ Expiration Date: ___________________(Mo/Yr) Card Holder Signature: ______________________________________ P.O. Box 348 Garibaldi, OR 97118 Phone: (503) 322-3316 Fax (503) 322-0049 |