Chesham Creek - Merchandise Order Form

Chesham Creek Merchandise Order Form

Chesham Creek Merchandise
P.O. Box 54
Sperryville, VA 22740-0054

Email: oldragmtn1@netzero.net
URL: http://www.CheshamCreek.com

Complete this form and mail it with your payment to the address on the left. Please remember to add the appropriate shipping and handling costs to your order.

Shipping Cost
$ 4.95 per CD

Please fill out the form below by entering the number of items desired and the subtotal in the appropriate row. Be sure to include your order total and all payment and shipping information on your order form. Your order will be shipped within 3 weeks of receipt of payment.

Payment Information
Check ___ Money Order ___

Ship To
Name __________________________________ Phone _________________________
Address __________________________________________________________________
City ____________________________ State _____ Country _______ Zip Code ________

Quantity	Item Number	Item Description	Unit Price	Subtotal
________	CC0001	CD: Mountain Legacy	$ 15.00	________
Order Subtotal			$ ___________

Shipping and Handling			$ ___________
Order Total			$ ___________