PLEASE TYPE OR PRINT NEATLY IN BLOCK CAPITALS

Billing Address:

Name _________________________________________________________________

Address ______________________________________________________________

______________________________________________________________________

City/town ____________________________________________________________

Province/state _______________________Post/zip code __________________

Country ______________________________________________________________

Daytime phone number _________________________________________________

FAX number ___________________________________________________________

E-mail address _______________________________________________________

 

Shipping Address: (if it's different from your billing address)

Name _________________________________________________________________

Address ______________________________________________________________

______________________________________________________________________

City/town ____________________________________________________________

Province/state _______________________Post/zip code __________________

Country ______________________________________________________________

 

Payment: [ ] Credit Card [ ] Debit Card
[ ] Cheque [ ] Money Order

[ ] No shipping: Pick up the product from our store in Portland OR.

[ ] Notify me by e-mail when new products are released.

Select the products you wish to order

HUDNUT PRODUCTS

Product Code - Price - S&H

Sample:
[ ] MIN 01 - $22.00 - $5.00

_______________________________________________________________________

Shipping and handling (Please add shipping & handling fee)

TOTAL (ALL PRICES ARE IN US DOLLARS) _____________

_______________________________________________________________________

Payment by Mastercard, American Express or Visa card:

We can only accept American Express, Mastercard or Visa cards (no
Discover cards, please.) We will need the following information:

Credit card number: ___________________________________________________

Expiry date:___________________________________________________________

The name as it appears on the card: ___________________________________

The signature of its owner authorizing us
to debit it for the amount indicated above: ___________________________

We are unable to accept credit card orders without the signature of the
card holder.

_______________________________________________________________________

Mail this form to:
Hudnut Company Inc.
730 NE 21st. Avenue,
Portland OR 97232.

If you're paying by credit card, you can FAX it to 1-503-233-0705.

FINE PRINT: Orders are processed immediately and cannot be modified or
cancelled after they are submitted. Products ordered may not be returned
for a refund or exchanged.
If you request shipping, your order will be shipped by FedEx.