Jade Panther Order Form

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Please print Legibly

Bill To:

Name:
Mailing Address:
City, State, Zip Code:
Telephone:
Email Address:

Ship To:

Name:
Mailing Address:
City, State, Zip Code:
Telephone:

Shipping & Handling Up to $30.00 .................. $5.00 $30.01 - $60.00 .............. $7.00 $60.01 - $100.00 ............ $11.00 $100.01 - $200.00 .......... $12.00 $200.01 - $300.00 .......... $14.00 $300.01 - $400.00 .......... $16.00	Most items are sewn when we receive the order. Please allow 4 to 6 weeks for delivery. Orders paid by personal checks will not be shipped until the check has cleared the bank. Mail To: Jade Panther P.O. Box 483 West Fargo, ND 58078-0483	Subtotal
		Tax *
		S & H
		Misc.
		Total