Handy Order Form

Please print this form*, fill in the necessary information, sign if using credit card, and mail with check, money order, or VISA or Mastercard number to:

Williams Maple Farm
35 Swamp Road
Cornwall, VT 05753
USA

*To print form: Click File, then Print in your browser; or File, then Save..., and print from your disk.

Products: Golden Delicate (Fancy), Amber Rich,and Dark Robust Price
Gallon 73.00
1/2 Gallon 49.00
Quart 33.00
Pint 25.00
1/2 Pint 18.00
Six Pack 33.00
8.45 oz. Maple Leaf Bottle 20.00
3.45 oz. Maple Leaf Bottle 17.00
1.7 oz. Maple Leaf Bottle 8.00


Mailing address

___________________________ First name
___________________________ Last name
___________________________ Mailing address line 1
___________________________ Mailing address line2
___________________________ City
___________________________ State and Zip code
___________________________ Phone Number

Shipping address if different from mailing address

___________________________ First name
___________________________ Last name
___________________________ Mailing address line 1
___________________________ Mailing address line2
___________________________ City
___________________________ State
___________________________ Zip code

Shipped UPS or Priority Mail

Choose method of payment:
___Check or money order
___VISA
___Mastercard

___________________________
Card number
________
3 digit security code
________
Expiration date

Signature____________________________

Quantity Description (size) Grade Total Amount
_______ ___________________ __________ _____ __________
_______ ___________________ __________ _____ __________
_______ ___________________ __________ _____ __________
_______ ___________________ __________ _____ __________

________Order total

___If you would prefer not being on our mailing list, please check here

Copyright ©2000 Kevin Williams and Williams Maple Farm

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