INTERNET - ORDER FORM
Ship To Name:_______________________________________________________Date: / /
Street Address:_________________________________________________________________
_____________________________________________________________________________
City:_________________________________ State:____________________Zip:____________
All products are packed 24 packages to a box, except for the 4.oz gift box which is packed with approx. 66 mints.
Minimum order is $34.00 or more. All prices include shipping and handling.
To order: Send the completed order form along with a money order or check, made out to
C. Howard Co.,Inc. for the total amount and send to:
QUANTITY
PRODUCT DESCRIPTION
PRICE PER BOX
AMOUNT
Choward’s Violet Mints
Choward’s Lemon Mints
Choward’s Spearmints
Choward’s Peppermints
Choward’s Scented Gum
Choward’s 4oz. Gourmet Violet Gift Box
Choward’s T-Shirt (Circle your size) - (Large) (X-Large)
Choward’s Embroidered Hat
$17.00
$17.00
$17.00
$17.00
$17.00
$ 3.99
$14.00
$13.50
*Please add applicable sales tax for merchandise
on orders delivered to NY.*
**For shipments to Hawaii or Alaska, please add $2.00
per package additional shipping. Alaska or Hawaii orders
are shipped via U.S.P.S. Please allow up to 4 weeks for delivery.**
Sub-Total
*Sales Tax*
**Added
Shipping
Fees**
TOTAL
C. Howard Co., Inc.
Attn. Internet Sales
1007 Station Road
Bellport, NY 11713
Personal checks will be held for 2 weeks from the date
they are deposited before product is shipped.
Money Orders allow us to ship product at the time of receipt.
Remember minimum order is $34.00 or more. Sorry, we do not accept returns on food items.
Order form for use only in the U.S.A.
This order form EXPIRES ON 6/30/12
Choward’s Guava Candy
$17.00