Breath of the West—Mail Order Form

Print and mail this form to Breath of the West, 442 North Hamilton, Powell, WY 82435

ITEM DESCRIPTION

use abbreviations COLOR

QUANTITY

PRICE EACH

TOTAL

Rock 'n Sage—small (3.5")

$14.00

Rock 'n Sage—medium (4")

$18.00

Rock 'n Sage—large (5")

$23.00

Tapers—7.5" (pair)

$12.00

Tapers—11" (pair)

$14.00

Horseshoe Candleholder

n/a

$25.00

Buffalo Chips Fire Starter (2)

n/a

$10.00

Subtotal:

WY residents add State tax:

Your Name:

ORDER TOTAL:
Make checks payable to Breath of the West

Order will be shipped on receipt of payment. Please allow 1 week for personal checks to clear. We will notify you by e-mail of shipment date.

Address:

City, State, Zip:

E-mail:

Prices include shipping for domestic orders. Contact us for a quote for international shipping.

SHIP TO:

Is this a gift?

Yes

Name:

Would you like to include a special message?

Yes

Address:

Message to read:

City, State, Zip:

Country: