About 20 years ago

Order Blank

For orders of up to 2 sticks, list each stick separately on the Order Blank on right.  For more than 2 sticks, use the table below specifying each stick preferred.

Cut and paste this Order Blank into your email and send to:  patriothillfarmbc@verizon.net

(No Post Office Box addresses, please)

Name: _________________________________

Street: _________________________________

City: ___________________________________

State: __________________________________

Zip Code: _______________________________

Telephone Number:______________________

 

 

1.  Stick length desired: _____________inches

 

Stick Color:   _____________________

Grip Color: _______________________

Use the exact name of color as shown

on the webpage. 

Attach Vinyl Black tip?   YES     NO

(if No, I will send the vinyl tip with the stick so you

can attach it later.)

 

2.  Stick length desired: _____________inches

 

Stick Color:     ____________________

Grip Color: _______________________

Use the exact name of color as shown

on the webpage. 

Attach Vinyl Black tip?   YES     NO

(if No, I will send the vinyl tip with the stick so you

can attach it later.)

GRIP NAME AS SHOWN ON WEBSITE STICK COLOR STICK LENGTH TIP ATTACHED?  YES/NO
1.      
2.      
3.      
4.      
5.      
6.      
7.      
8.      
9.      
10.