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Wes Terner’s Outfitter
Order Form
| Send To: |
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Choice of Payment: |
| Name______________________ |
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_____Check/Money Order
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Address____________________
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_____Credit Card |
| City________________________ |
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Visa__ Master Card__ |
| St., Zip_____________________ |
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Credit Card Acct. #______________________ |
Phone
( )________________
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Name of Card Holder____________________ |
Fax #
( )___________________
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Expiration Date______-______ |
| E-Mail_________________________ |
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| If ordering by credit card please supply
credit card billing address if different than shipping address. |
| Credit Card Billing Address |
| Address_______________________________ |
| City, St. Zip___________________________ |
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Description |
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Quan. |
Unit/Price |
Total |
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| Sub Total |
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| Idaho residents add 6% sales tax |
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| Shipping & Handling |
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| Total Amount |
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Shipping and Handling Charges for U.S.
Only
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Up to 14.99 |
$5.50
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$15.00 to 49.99 |
$8.95 |
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$50.00 to 99.99 |
$11.95 |
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$100.00 to 199.99 |
$14.95 |
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over $200.00 |
$19.95 |
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PLACE ORDER BY: Phone/Fax 208-667-7051
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BY MAIL: Wes Terner’s Outfitter
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PMB 257
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212 Ironwood Dr. Suite D
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Coeur d’Alene, ID 83814
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(BACK)
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