Mail Order Form

Wildgrown.com
Mike Lee
P.O. Box 103
Montgomeryville, PA 18936

Tel: 215-540-5890

Name:
Address:
City:
State:	Zip:
Day Time Tel:
Email:

Desired Shipping Date: ________________________

Item/Description	Quantity	Unit Price	Amount
Product Subtotal:
Shipping & Handling fee (refer to table below):
Total:

Shipping Charges:

total weight	shipping Charge
2 oz. to 16 oz.	$5.00
1.1 lb. to 5 lbs.	$10.00
6 to 10 lbs.	$18.00
11 to 25 lbs.	$30.00
26 to 50 lbs.	$45.00
51 to 99 lbs.	$75.00
100 lbs or more	$95.00 for every 100 lbs

* All orders will be shipped via USPS Priority Mail with delivery confirmation.
* It will take 2-3 business days to deliver once shipped.