| Full Name - |
| Street Address - |
| City, State, Zip Code - |
| Telephone - |
| Email Address - |
| Item Number | Quantity - 2 serving size | Quantity - 24 serving size | Total Price |
|
|
1
|
$2.00 | |
| # 10-413 |
5
|
$135.00 |
| Item Number | Quantity - 2 serving size | Quantity - 24 serving size | Total Price |
| # | $ | ||
| # | $ | ||
| # | $ | ||
| # | $ | ||
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| # | $ |
| Sub-Total | $ |
| Shipping and Handling Sub-Total ( see below for S & H prices ) | $ |
| Total | $ |
Please print this order form and
mail it with a Check or Money Order Addressed to: Ms. Deanne Flanagan
RR# 2 Box 391
East Lebanon, Maine 04027
Shipping and Handling Charges
| Under $49.99 |
|
| $50.00 - $99.99 | $11.99 |
| $100.00 - $149.99 | $15.99 |
| $150.00 - $199.99 | $19.99 |
| $200.00 - $299.99 | $23.99 |
| $300.00 - $399.99 | $27.99 |
| $400.00 - $499.99 | $31.99 |
| $500.00 - $599.99 | $35.99 |
Any order over $600.00 please email for Shipping and Handling quote!
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