TO USE this form- Print a copy to mail or fax or To send via email, go to File and choose send page by email. Then on the email form, enter your information, it will not copy your information if you type before you paste to email and we will receive a blank order form.

LODGEWOOD MFG.

PO Box 611, 131 Center Street, Whitewater, WI 53190-0611

Phone 262-473-5444 or Fax 262-473-6448

NAME:
ADDRESS:
CITY:
STATE AND ZIPCODE:
PHONE:
E-MAIL ADDRESS:
Quantity ................Description................. Price ..Amount..
    Subtotal
  Wisconsin residents add WI tax 5.5%
    Shipping & Handling
    Total
Shipping, Handling & Insurance
For UPS or PRIORITY MAIL follow guidelines below;
MINIMUM S&H charges are $9.00 for the first 1lb. and $.80 per additional lb. up to 5# or $250.00 value
ORDERS OVER $250.00 and/or more than 5 pounds, BASE RATE is $10.50 plus $.75 per added #
If you are not sure how to figure, Call us and we will be glad to give you the exact rate.

RAMRODS REQUIRE AN ADDITIONAL $5.00 FOR CONTAINER
ALL MUSKETS HAVE A MINIMUM $30.00 SHIPPING FEE
COD REQUIRE AN ADDITONAL $8.00
SPECIAL SHIPPING AVAILABLE -(ie; NEXT DAY; REGISTERED MAIL)PRICES ON REQUEST

Method of payment:Money Order Check Credit card: Mastercard Visa. Discover

Card Number + 3 from backExpiration Date Signature ________________________

FAX your order to - 262-473-6448 or email; lodgewd@idcnet.com

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