ORDER FORM

For 24   2.5 oz size tubs

                 

  ORDER FORM 2.5oz                                       

  PURCHASER

  Name: _____________________________  

  Street________________________

  State:_______           Zip:__________         

  Phone #:___________________ Email_________________________                   

  SHIP ORDER TO:

  Name:_______________________________

  Street________________________

  State___________     Zip________   

  Phone #_________________  Email_______________________ 

  SHIPPING AND HANDLING(check time zone in which package will be delivered):

  TIME ZONE: 

         EASTERN_______CENTRAL_______MOUNTAIN_______PACIFIC_______

  SHIPPING COST:    

          EASTERN______CENTRAL_______MOUNTAIN_______PACIFIC_______

        2 DAYS $15.00       2 DAYS $18.00          3 DAYS $36.00                3 DAYS $40.00

  Orders for Alaska or Hawaii email for quote:

  REQUESTED MONDAY SHIP DATES:  

  MONTH ______________ DATE__________

        Order here for ONE case of 2.5 oz little tubs(each case is a separate order ):

        Total 2.5ozlittle tubs (must equal 24 tubs):  ______     

  ORDER QUANTITY by: little tubs 2.5oz size tubs(24 count):

      Squire Mtn Original CHEDDAR Tub Cheese    _______

      Squire Mtn OLIVE &  PIMENTO  Tub Cheese  _______

      Squire Mtn GARLIC & HERB  Tub Cheese        _______

      Squire Mtn HORSERADISH  Tub Cheese         _______

      Squire Mtn BACON CHEDDAR Tub Cheese    _______

      Squire Mtn PORT WINE Tub Cheese             

                                                               Product cost:   $ 60.00___________

                                                               Shipping cost: $_______________ 

                                                                SUB-TOTAL:  $_______________

                                                                 less coupon:   $_______________

                                                           ORDER TOTAL: $_______________

MAIL TO:  SQUIRE MOUNTAIN, LLC,  P.O. BOX 149, STANDISH, ME. 04084

MAKE CHECK OR MONEY ORDER PAYABLE TO  SQUIRE MOUNTAIN ,LLC

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Mail with a check  or money order.