For faster delivery you may order online using your credit card or print this form and fax it to (607) 936-8307. To place an order via "snail mail" print this order form, fill it out, and mail it with your check, money order or credit card information to:
SELECT PRODUCTS
Dept. GS
P. O. Box 667
Elmira, NY 14902
United States of America
NOTE: IF YOU DON'T HAVE A PRINTER,BUT WISH TO MAIL US YOUR ORDER, SIMPLY WRITE THE INFORMATION ON A PIECEOF PAPER.
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| Sizes | Quantity | Cost Ea. | Total |
| (One 3 ounce Jar) Small | $24.95 | ||
| (One 6 ounce Jar) Medium | $39.95 | ||
| (2 Jars = 9 ounces) Large | $53.95 | ||
| (2 Jars = 12 ounces) X-Large | $64.95 |
Prices include postage inside the continental United States. All others add $13.00 US Shipping/Handling.
| Name: | ______________________________________ |
| Address: | ______________________________________ |
| City: | _______________State:____________Zip:__________ |
| Country: | ______________________________________ |
Email Address: __________________________________
Phone No.: ______________________________________
For credit card orders:
Type:______________________
No._________________________________
Exp. Date:__________________