MFTHBA MERCHANDISE ORDER FORM

TO INSURE DELIVERY, PLEASE LIST A STREET ADDRESS. UPS WILL NOT DELIVER TO A PO BOX.

ORDERED BY: DELIVER TO (IF DIFFERENT THAN ORDERED BY):
FIRST NAME                                       LAST NAME COMPANY NAME
ADDRESS FIRST NAME                                       LAST NAME
CITY                                                                               STATE                  ZIP ADDRESS
DAYTIME PHONE CITY                                                                               STATE                  ZIP

IF YOU ARE NOT HOME DURING THE DAY,
WE WILL GLADLY SHIP TO YOUR WORK ADDRESS,
IF THAT IS PERMITTED WHERE YOU WORK.

ITEM COLOR SIZE PRICE  EACH QTY TOTAL AMOUNT
           
           
           
           
           
           
SHIPPING AND HANDLING:       MDSE TOTAL  
$0-$4 = $4
$5-$25 = $9.50
$26-$50 = $11.50
$51-$75 = $13.50
$76 and Up = $15.50
Foreign = Call for Rates		       S & H  
      TOTAL AMOUNT  

 

PAYMENT METHOD (PLEASE DO NOT SEND CASH).
WE ACCEPT CHECKS, MONEY ORDERS, GIFT CERTIFICATES, MASTERCARD AND VISA ONLY.
___ CHECK OR MONEY ORDER
___ GIFT CERTIFICATE
___ MASTERCARD
___ VISA

CREDIT CARD NUMBER ________ - ________ - _______ - _______    EXPIRATION DATE: MO____ YR ____

SIGNATURE______________________________________________

MAIL ORDERS TO:
MFTHBA
PO BOX 1027
AVA, MO 65608

PHONE 1-417-683-2468
FAX 1-417-683-6144
OFFICE HOURS M-F 8:30 AM - 4:30 PM CENTRAL TIME