Sierra Lands Beef Order

This is an explanation of the purpose of the form ...

Please provide the following contact information:

Name

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Work Phone

Home Phone

E-mail
Please provide the following ordering information:

QTY DESCRIPTION

You may pay COD (Check or Cash on Delivery)
or by Credit Card:

I wish to pay when my beef is delivered.

I wish to pay by credit card and my information is below:

Payment Amount $150 for 20 lb. $280 for 40 lb. $560 for 1/8
$960 for 1/4 $1500 for 1/2 beef

Credit Card #

Expiration Date

(You may call our office at (559)855-3473
if you prefer to give your credit card information by phone.)

Comments:

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Copyright © 2003 [OrganizationName]. All rights reserved.
Revised: 07/20/11