Jed's Maple Products Order Form

Ordered by:
Street*: City:
State: Zip: Country:
Phone: Email:

ORDER #1
To:
Street*: City:
State: Zip: Country:
Gift Message:

Catalog Qty Description Total
       
       
       
       
Order #1 Sub-Total  
Order #1 Shipping  
Order #1 Total  

Order Subtotal Shipping
USA East
Shipping
USA West
$0.01 - $30.00 $11.00 $14.00
$30.01 - $60.00 $14.00 $17.00
$60.01 - $90.00 $20.00 $25.00
$90.01 - $150.00 $26.00 $36.00
NOTE: Shipping price is based on the Order Subtotal
and whether it is being shipped East or West of the Mississippi River.

Payment: Check Money Order VISA/MC

Card#:
Expiration:
3-Digit (on back of card, last 3 of 7 digits):

Signature:

Order #1 Total  
Order #2 Total  
Other Totals  
Grand Total  
*UPS does not ship to a P.O. Box. Please use a street number.

Contact us for next day/2nd day shipping. Include additional orders on back or attach sheet. Questions? Call us at (866) 478-7388 or email at wheeler@jedsmaple.com. Mail order form to: Jed's Maple Products, 259 Derby Pond Road, Derby, VT 05829