EZ ORDER FORM

THE BUCK BANK    Phone (541) 826-2729     Fax (541) 826-9717

Mail to: The Buck Bank, 2344 Butte Falls Hwy., Eagle Point, OR. 97524

Name:
Street Address for Shipping: 
Mailing Address: (if different from above)
City, State & Zip:
Phone: 
(Optional) Email:
Buck Name or Item Description:
Quantity
Price
$ Total
       
       
       
       
       
       
       
       
       
       
       
Total for items listed on this page:
 $
(List additional items on back or print twice for a second page)
Total of items listed on back
or Page 2:
$
If ordering semen, add $10 nitrogen fee:
 $

Credit Card: (Check one)

   ___Mastercard      ___Visa

Card#: _____-_____-_____-_____

Expiration Date: Mo.____ Yr.____
Shipping & Handling charges:
(Under $20 total, add $5.
Over $20, add $8.)
 $
If using a credit card,
add 5% Credit Card fee:
 $
TOTAL ENCLOSED:
 $