ORDER FORM

For twelve 6oz  size tubs

                 

  ORDER FORM 6oz

  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 quotes:

   REQUESTED MONDAY SHIP DATES:  

   MONTH ______________ DATE__________

   Order here for ONE case of 6oz Tub Cheese(each case is a separate order ):

   Total 6oz Tubs Cheese (must equal 12 tubs):     

   ORDER QUANTITY by:  

   Tub Cheese 6oz size (12 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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