Please Print this form, fill it out & send it to us at :
DAVE & JANE STORM
Pea Ridge Gamebird Hatchery
1330 Hwy V
Hartville Missouri 65667
Phone: 417 741 7737
Please make check payable to:
DAVID OR JANE STORM
Name............................................................................................................
Address.........................................................................................................
City....................................................State......................Zip
Code...............
For Order Confirmation:
E-Mail Address..............................................................................................
Phone
#..........................................................................................................
State
or Federal Game Bird License #..................................
Ship USPS Priority Mail.........................
Ship ASAP..................
Ship USPS Express Mail.........................
Do not Ship before...............
(Quanity) (Eggs/Chicks) (Type of Bird) (Price ) (Total)
1_______________/__________________/___________________________________/_______________/____________
2_______________/__________________/___________________________________/_______________/____________
3_______________/__________________/___________________________________/_______________/____________
4_______________/__________________/___________________________________/_______________/____________
5_______________/__________________/___________________________________/_______________/____________
SUBTOTAL: $_________.____
SHIPPING COSTS: $_________.____
TOTAL $_________.____
30% DEPOSIT (Required
for placement of order) $_________.____
Note: Orders are shipped according to deposit placement date.*
Balance
due prior to shippment: $_________.____
There is a mim. order of day old chicks for shipment. 25 Pheasants / 50 Quail.
Most chicks will be shipped Priority Mail unless specified Express Mail.
Eggs will be shipped Priority Mail. All orders must be paid in full before shipment can be made.
We accept money orders, cashiers checks, & personal checks.
If you send a personal check, please allow 2 weeks for check to clear.
Or you may use your credit card on our secured on-line server.
*Order will be placed on day check clears.
