Order Form
Directions: Choose File || Print
from your web browser to print this form, then fill it
out and fax it to us.
We
will ship as soon as we receive payment. Thank you!
FAX #: 616-772-2969
NAME:
_____________________ PHONE: (Area Code) ______________
ADDRESS: _________________________________________
CITY: _________________
STATE: _____ ZIP CODE: ________
REQUESTED
SHIPPING DATE: ____________
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BREED
AND SEX (as hatched, pullets, or cockerels) |
Price |
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SECOND
CHOICE |
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| TOTAL FOR MERCHANDISE: |
_______ |
| POSTAGE ON CHICKS: |
_______ |
| SPECIAL SERVICES: |
_______ |
| TOTAL: |
_______ |
CREDIT
CARDS WELCOME
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Expiration Date: __________
Year ______
Signature:
_________________________
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Credit Card Account No.
(Please
recheck to make sure all digits are correct.)
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Click to Go Back to Order Page
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