Order Form

Home Holderread Waterfowl Farm P.O. Box 492, Corvallis, OR 97339 1(541)929-5338 Thank You for ordering and supporting our preservation work! Area Code________ Phone #______________________________ Name_________________________________________________ Address_______________________________________________ City___________________________ State_______ Zip_________ e-mail address__________________________________________
Quantity	Description	Dates Preferred	Price

Add $250 for Health Certificate if shipment is going to Canada _____________

Please indicate if you want/need NPIP papers _____ _

Select □Express Mail or □Priority Mail Option (You are in Zone ______) _____________

Total____________

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