Print-able Order form

PRINT THIS ORDER FORM AND MAIL WITH PAYMENT INFORMATION TO: Country Plus 20 Main Street Hopkinton, MA United States 01748 Phone #: 508-435-9613 Fax #: 401-567-0872 Email: countryplushopkinton@verizon.net
Circle Payment Method: Check Money Order VISA MasterCard Discover
Print Name:
Address:	Email:
City:	Credit Card Number:
State & Zip:	Expires:
Telephone:	Signature:_____________________

Item Name and Description	Quantity	Price














Subtotal:
Shipping and Handling:
MA residents must add 5% sales tax-
MAKE CHECKS PAYABLE TO: Country Plus	Total :

Thank you for shopping at Country Plus.