|
Please print this form and send it with a check payable to HomePlaceProducts.com, PMB 55, 3735 Palomar Centre, Suite 150, Lexington, KY 40513, or with your MasterCard or Visa information below or call us at 859-621-5511 (fax number is 859-296-0650). Thank you! |
| Name | ____________________________ Organization _________________________ |
| Mailing Address | ____________________________ City/State/Zip ________________________ |
| Street Address | ____________________________
City/State/Zip ________________________ Include organization name on shipping label? ___ Yes / ___ No |
| Telephone | (___________) _____________________________ |
| MC ___
| Visa ___ AMEX ___ | Discover ___ |
Card
#________-_________-_________-_________ Exp.date______________ <--- Please check which card you are using. |
| Signature: | __________________________________________ |
| Qty. |
Item |
Material* | Part # | Price Each | Total Price |
| . | Weed Bandit Narrow | S.S. | #291 | $37.95 | $_________ |
| . | Weed Bandit Medium | C.S. | #252 | $22.95 | $_________ |
| . | Weed Bandit Medium | S.S. | #292 | $39.95 | $_________ |
| . | Weed Bandit Wide | S.S. | #293 | $41.95 | $_________ |
| . | Weed Bandit Jr. | S.S. | #591 | $29.95 | $_________ |
| . | Weed Bandit Jr. | C.S. | #591A | $ 9.95 | $_________ |
| . | Master Turner | S.S. | #704 | $24.95 | $_________ |
| . | Rake 'n Roll | N/A | #601 | $29.95 | $_________ |
| . | Scooper Sifter | C.S. | #700 | $21.95 | $_________ |
| . | Scooper Sifter | S.S. | #600 | $29.95 | $_________ |
| Couch Caddy (2 pocket) | N/A | CC-02 | 22.95 | $_________ | |
| . | Art Prints: | N/A | . | . | . |
| . | Wintertime | . | Cat.#1 | $55.00 | . |
| . | West Main | . | Cat.#2 | $55.00 | . |
| . | Birches | . | Cat. #3 | $55.00 | . |
| . | Beachcombers | . | Cat. #4 | $55.00 | . |
| . | Sea & Sandpipers | . | Cat.#5 | $40.00 | . |
| . | Old Cabin | . | Cat. #6 | $55.00 | . |
| . | . | . | . | . | . |
| . | . | . | . | . | . |
| . | . | . | . | . | . |
| . | * Stainless Steel (S.S.) or Carbon Steel (C.S.) | . | $_________ | ||
| . | __________________________ | . | $_________ | ||
| . | Sub Total | . | $_________ | ||
| . | 6% sales tax (or attach tax exempt form) KY Residents Only | . | $_________ | ||
| . | Shipping
& Handling * Long-handle tools, please add $11.95 or * All other items, please add $9.95 |
. | $ | ||
| . | Total | . | $_________ | ||
| NOTE: Pricing for Dealers, Distributors and Catalogs differ. Please contact HomePlaceProducts.com for pricing information. | |||||
| *Applies
to the United States. Please contact HomePlace Products.com for rates outside the USA. THANK YOU in advance for your order! |
KENTUCKY
Residents Only |
|
|
HomePlaceProducts.com |
