18612 Main P.O. Box 617 Conway Washington, USA. 98238
Tel: 1-360-445-6003 Fax: 360-445-4001
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Mail/Fax Order Form
To print a copy for mailing or Faxing, click on your browsers print button
Name:_________________________ Shipping Address:___________________ City:___________
State/Prov:___________ Zip/Post:_______Telephone Number:______________ Fax:______________
| No. | Item# | Description | Size | Quantity | Price | Amount |
|---|---|---|---|---|---|---|
| 1 | _Flake__ | __Color Enhancer_________ | 10-Oz | _______ | __TBA___ | ________ |
| 2 | _Flake__ | __Color Enhancer_________ | _2-Oz | _______ | ___TBA___ | ________ |
| 3 | _Pellets | __Mini_________________ | _6-Oz | _______ | ___TBA___ | ________ |
| 4 | _Worms__ | __Blood Worms Freeze Drd_ | _2-Oz | _______ | __TBA___ | ________ |
| 5 | _Flake__ | __Fancy Doc's secret receipe! | _1-Oz | _______ | ___TBA___ | ________ |
| 6 | _Water__ | __IchX & Clout_____________ | 10-tab | _______ | ___TBA___ | ________ |
| 7 | _Water__ | __pH Down________________ | _3-Oz | _______ | ___TBA___ | ________ |
Order Total:_______________ Wash State Res
add 7.7% Sales Tax:_______
Shipping charges:___________ Final Total:___________________________
SHIPPING: Please add $4.95 for shipping on orders under $20. Add $10 for shipping on tanks. Shipment of orders will be made within 5 days of receipt of order. A telephone or contact name MUST be supplied for all orders.
TERMS OF SALE: All orders must include a street delivery address and telephone number for shipment.