Order Form
Please fill out this form completely and then mail it, along with your check or money order, to the address listed at the bottom of the page.

Name: ____________________________________________________________
Mailing Address: ____________________________________________________
City: _________________________________ State: ______ Zip: ____________
E-mail Address: ____________________________________________________
Daytime Phone: __________________ Evening Phone: _____________________
Special Instructions: _________________________________________________

__________________________________________________________________
Qty. Number Description Price Total
         
         
         
Merchandise Total 

U.S. Shipping and Handling (Contact us for shipping cost)

TOTAL DUE 

 
 
 
 

Mail To:

J M Steele
PO Box 411
Gold Beach, OR 97444

www.jmsteele.com
jmsteele1@charter.net