Print-able Order form

PRINT THIS ORDER FORM AND MAIL WITH PAYMENT INFORMATION TO: The Peppermill Guy 197 State Rd. Valencia, PA United States 16059 Phone #: 724-898-3509 Fax #: Email: tdog@nauticom.net
Circle Payment Method: Check Money Order VISA MasterCard
Print Name:
Address:	Email:
City:	Credit Card Number:
State & Zip:	Expires:
Telephone:	Signature:_____________________

Item Name and Description	Quantity	Price














Subtotal:
Shipping and Handling:
PA residents must add 6% sales tax-
MAKE CHECKS PAYABLE TO: Gregory A. Savage	Total :

Thank you for shopping at The Peppermill Guy.