P.O. Box 1975 Brewster WA 98812

Telephone (509) 689-3211

Order Form

Ship To:

Payment By:

Check:

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Date Ordered:

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Money Order:

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Will you accept substitutions? Yes __ No __

Invoice:

Description (Name)

Qty.

Unit Cost

Total Amount

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Subtotal

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Washington State Residents Only (Sales Tax)

ST 7.6%

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S/H Charge

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Total