revised 11/19/08 

Wellcat Herbs
Ruth Roy's Herbs
2418 Long Lane, Lebanon, PA 17046  717-279-0184
Email: wellcat@comcast.net
ORDER FORM (Please print clearly)
Name_________________________________________________________
Shipping Address:
Street _____________________________City___________________________
State____ Zip_______
E-Mail__________________________    Phone _(___)_____________________                  
          Item                                                         Quantity         Price          Total
          _______________________________|__________|__________|__________
          _______________________________|__________|__________|__________|             
          _______________________________|__________|__________|__________|
          _______________________________|__________|__________|__________|
          _______________________________|__________|__________|__________|          _______________________________|__________|__________|__________|
          _______________________________|__________|__________|__________|
        
          Sub Total                                                       ____________
          Sales Tax (PA residents add 6%)                      ____________
          Shipping **                                                     ____________
          Total                                                               ____________

          Method of Payment (Check one)
	___Personal Check US funds only (Must accompany order)___Money Order US funds only (Must accompany order)
	___ VISA  ____ MasterCard ____ Discover
	Card Number: ____ - ____ - ____ - ____ Exp. Date __/__

 **Shipping & Handling - We usually use Priority Mail. The price structure: for orders under $15, add $5.00; $15 to $30, add $8.00; $30 to $60, add $10.00. 
During the holiday season we will do our best to expedite all orders! Otherwise, please allow 2-6 weeks for delivery (depending on availability). 

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