Order Form

20 Marshall Rd.
Fitchburg, MA 01420
Phone: (978) 729-5583
apparel@baystateharleypullers.com
http://www.baystateharleypullers.com

Order Form

Name, First and Last:
Street Address:
City:
State:    Zip Code: 
Email Address:
Phone #:

Item Description  (include size & color)

Item Price  x  Qty
Item 1: $ # $
Item 2: $ # $
Item 3: $ # $
Item 4: $ # $
SUBTOTAL
Shipping  (See chart below)

$

All items are shipped U.P.S. or USPS

TOTAL

    1 - 2 items  .....     $2.00 shipping  3 - 4 items  .....     $3.50 shipping
    5-9 items        ...      $6.00 shipping .... 10+ items .... call
PAYMENT INFORMATION: print form & mail with check or money order. Checks made payable to: David Wheeler
Questions/ Comments: