Print-able Order form

PRINT THIS ORDER FORM AND MAIL WITH PAYMENT INFORMATION TO: Primitives by Treece 1711 N 6th Street Grand Forks, North Dakota United States 58203 Phone #: 701-215-8608 Fax #: Email: tr_holter@yahoo.com
Circle Payment Method: Check Money Order VISA MasterCard Discover AmericanExpress
Print Name:
Address:	Email:
City:	Credit Card Number:
State & Zip:	Expires:
Telephone:	Signature:_____________________

Item Name and Description	Quantity	Price














Subtotal:
Shipping and Handling:
North Dakota residents must add 6.75% sales tax-
MAKE CHECKS PAYABLE TO: TR Treece Holter	Total :

Thank you for shopping at Primitives by Treece.