Order

Thank you for selecting from our on-line store. Please complete this form and return it to us by printing your completed form and sending it via FAX to 1-740-454-3064.
Your satisfaction is guaranteed.

Order Form
Product	Item	Description	Price	Quantity	Total




				Subtotal

				Tax
				Total

Shipping Address
Name
Address
City		State
Country		Zip
Email

Billing Address
Check if same as Shipping Address
Name
Address
City		State
Country		Zip
Email

Billing Information
Credit Card
Name on Card
Card Number
Expiration


	Send email to: Ritchey Produce with questions or comments. Copyright © 1999 Ritchey Produce Company, Inc.