PINE NEEDLE ORDER FORM

Mail to: Lori Peirson, P.O. Box 146, Dulzura, CA 91917. Domestic orders only.
Item
Quantity     Total    
Coulter Pine Needles, $3.00/4 oz. US                                                            
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Priority Shipping (see table) -----------
TOTALS

Priority Shipping Rates
Up to 1 lb. needles + packaging$4.80
Next pound$6.80

Name:
Address to ship to
(include P.O. box #,
apt. #, if any):

City:
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Country (optional):
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Phone (very optional):
Make checks/money orders payable to: Lori Peirson. No charge cards please.