Country Joy Order Form

This form is for payment by Checks, Money Orders or Charges to be mailed

Please Print or Type Clearly

Date___________________

Customer Name_________________________________________________________

Address_______________________________________________________________

City, State, Zip Code______________________________________________________

Phone Number___________________________

Email___________________________________

Charge # ________________________________ Visa____ MC____ Last 3 numbers on back of card_____________________

Quantity	Item Number	Description	Color	Price	Total








		Subtotal
		California residents please add 7 .50% sales tax.
		Total Due

All Items will have postage added to them. They will be sent either by US Mail or UPS. Please email

for Postage Costs.

Please make checks or money orders out to: