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Meadery of the Rockies Order Form
Please print, fill out, and fax this
form to (970) 464-0175.
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Customer Name:
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Customer Address:
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City:
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State:
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Zip:
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Phone:
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Email Address:
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Ship To:
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Shipping Address:
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City:
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State:
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Zip:
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Phone:
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Email Address:
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Item
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Quantity |
Cost Each* |
Total Cost |
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Total:
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$
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Less Discount (5% for web orders, %10 for a case):
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$
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Total w/discount
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$
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Sales Tax**:
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$
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Shipping***:
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$ Leave blank!
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Grand Total:
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$Leave blank!
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Credit Card type (Visa or Mastercard only), number, and expiration
date:
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Signature:
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| * For prices,
please see the
Wine & Beverage List.
** Colorado residents, and orders being shipped within the
state of Colorado, add 6% for sales tax.
*** Because shipping costs change, let us compute this
for you. We will call or email you with the shipping amount and the grand
total.
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