rocksandminerals.com

ROCKMAN'S TRADING POST
PO Box 2444, Thompson Falls, MT, 59873
Phone or fax: 406-827-7625

To order, print a copy of this form, fill it out and mail it to us or call or fax us at 406-827-7625. NOTE: Please include your e-mail address so we can contact you about your order if necessary. Thanks.

This Order Form For: Canada

Name: PO#: Date:
Address: City: Prov: Zip:
Phone: (         ) e-mail:

Item # Description Price ea. Quatity Amount
                             
                             
                             
                             
                             
                             
                             
                             
                             
                             

SUBTOTAL $_________

S&H: Add the greater of $8.00 or 35% of the SUBTOTAL amount.  $_________

TOTAL $_________

Method of Payment:

My Check/Money Order is Enclosed ____
Charge My: MC ___ VISA ___ Card #: _______ - ________ - ________ - ________
Exp Date: _____________
Authorized Signature: ____________________________________________