Please Print Both Pages

Order Form

Name _____________________________________________ Phone Number ______________________________

Address ___________________________________________ E-mail Address ______________________________

City ______________________________________________ State / Province ________ Postal Code ___________

Country (if other than US) _____________________________ Order Date _________________________________

Catalog #

Size

Color/Description

# of Items

Price

Subtotal

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Print two copies and keep one copy for your records with the name of the bank, account name, check number, and amount;

or the money order name/type and/or place of purchase, number and amount.

 Add Charges Here

Amount

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Surcharges (if applicable)

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Shipping: Books, CD's or Indicators

1-5 items add $5.00; 6-10 items add $10.00; 11-20 items add $15.00

Shipping Charges

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Total Amount Due

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Office Use Only

Date Received _____________________________________

Allow 4-8 weeks for delivery

Send Check or Money Order (no Credit Cards please) payable to T.R. Michels to:

Date Shipped _____________________________________

T.R. Michels 

Trinity Mountain Outdoors

3249 Upper 71st Street

Inver Grove Heights, MN 55076

TRMichels@Yahoo.com www.TRMichels.com

Back Order _______________________________________

Packed By ________________________________________

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