Murphy Orchards Printable Order Form

Murphy Orchards Printable Order Form

Billing Information:

Name _______________________
Address _______________________
City _______________________
State _______________________
Zip _______________________
Country _______________________
Phone _______________________
eMail _______________________

Shipping Information:

Name _______________________
Address _______________________
City _______________________
State _______________________
Zip _______________________
Country _______________________
Phone _______________________
eMail _______________________

Payment Method: ________ Check/Money Order ________ Credit Card
Credit Card #: _____________________________ Expiration: ___________
Item
Size
Quan.
Total
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________
________________________________ ____________ _____ $__________

Gift message or additional information:

________________________________

________________________________

________________________________

________________________________

________________________________

________________________________
Subtotal: $___________
Shipping: (See below) $___________
Shipping to USA:
  • Total of $15.00 add $7.95
  • $15.01 - $25.00 add $10.95
  • $25.01 - $35.00 add $13.95
  • $35.01 - $45.00 add $16.95
  • $45.01 - $55.00 add $19.95
  • $55.01 - $65.00 add $22.95
  • $65.01 - $75.00 add $25.95
  • Over $75.00 contact us
International Shipping will vary - contact us for cost.
Order Total
$______________

 

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Murphy Orchards
2402 McClew Road - Burt, NY 14028
Tel: (716) 778-7926 - Fax (716) 778-8979

[email protected]