| Bramble Berry Farm P.O. Box 327 Winslow, Arkansas 72959 |
Telephone and Fax: (479)369-1705 |
| Sold To: | Ship To: |
|---|---|
___________________________________ Name ___________________________________ Address ___________________________________ City, State, Zip ___________________________________ Telephone |
___________________________________ Name ___________________________________ Address ___________________________________ City, State, Zip |
| Item | Quantity | Price Each |
Total |
|---|---|---|---|
| Sub Total | |||
| Shipping & Handling (Minimum $12.00) | |||
| Total | |||
| Payment Method | |
|---|---|
| Check Enclosed, Make check payable to "Dwight Pense". | |
| Money Order | |