UnderHill Farms
187 21st Ave
Moundridge, KS 67107
Phone (620) 345-8415 Fax (620) 345-8412
Name _______________________________________________________________ Address (no P.O. Boxes)_____________________________________________ ____________________________________________________________________ City, State, Zip ___________________________________________________ Telephone __________________________________________________________ Payment Method: Payment Enclosed: Bill My Credit Card: ___Check ____Money Order ___MasterCard ___Visa ___JCB___AX ___DISC Name on Card _________________________________________________________ Card Number __________________________________________________________ Expiration Date ______________________________________________________ Signature ____________________________________________________________ Order Form: Quantity Item # Description Price each Total or per Pound _________ _________ _________________ _________________ _________ _________ _________ _________________ _________________ _________ _________ _________ _________________ _________________ _________ _________ _________ _________________ _________________ _________ _________ _________ _________________ _________________ _________ Subtotal ________ *Add shipping & Handling ________ Total ________
*Actual shipping charged incurred by Underhill Farms will be added to the product fees.
Orders shipped FOB Moundridge, KS. On orders $2,000.00 or more, freight is prepaid.