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Instructions:
For your Convenience...
1.  Print this form and use it for a reference while shopping on our site then call us with your order.  Having problems printing this page?   (see #3 below)
Please Note: You are not required to send this form in.
 

OR
  2.  Fax this form to our offices as a reference when you call in.  We will price out your order and notify you via telephone of the totals.
 

 OR
  3.  Click here to view our printable pdf form.  Printable PDF form:
   
 

Shopping list

Sending in your order by fax or mail?  Please include the below information
Name: E-Mail
Address: City: State: Zip:
Tel: Fax:
 
Item Description/Gourd Type Gourd Diameter Height Quantity or Amount Price  total

Dipper Gourds

 30 cents per in of neck lgth N/A neck___ins   $ $

Dipper Gourds

 30 cents per in of neck lgth N/A neck___ins   $ $

Gourd(s)

         $ $
Gourd(s)         $ $
Gourd(s)         $ $

Gourd(s)

         $ $
Gourd(s)         $ $
Gourd(s)         $ $
Gourd(s)         $ $
Gourd(s)         $ $
Other:         $ $
          $ $
 

Total Pieces:

    

Shipping:

 $

Tax (Cal residents only) 7.75 %:

 $
Totals: $
 

Quick pay information

We accept: Checks* - Money Order*

Makes Checks Payable to: Mojave Farm.

*Note:  When paying by check please remember that your order will ship within 24 hours of check clearance. 

TO EXPEDITE YOUR ORDER...
USE    
Use your Visa, MasterCard, Discover & AMEX for orders using our Paypal service.

Mojave Gourd Farm
42525 Silver Valley Road
Newberry Springs, CA 92365
Phone: 760-257-3139
Fax: 760-257-0072
info[at]mojavefarm.com
 

Copyright © Mojave Gourd Farm 2005