Retail Order Form
To submit an order, please print this form and mail to:
Feathered Frog Essentials
Attn: Retail Dept
3014 Oleander Drive
Osoyoos, BC Canada
Items Ordered:
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Item Number
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Item Description
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Size
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Quantity
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Price Ea
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Subtotal
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Order Total:
HST 12%
Shipping:
Total:
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For more items, please print and include a second form.
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Customer Information
*First Name ________________________
*Last Name ________________________
Company ________________________
*Email ________________________
Phone _________________________
Credit Card Information
*Card Type ________________________
*Cardholder’s Name As Shown On Card ___________________________________
*Card Number ______________________
*Expiration Date (mmyy) ____ / ____
*3 Digit Security Code _______________
*Required fields.
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Billing Address
*Address Line 1 ______________________
*City _______________________________
*State/Province _______________________
*Country _____________________________
*Zip/Postal Code ______________________
Shipping Address (if different from billing address)
Ship To Name __________________________
Address Line 1 __________________________
City __________________________________
State/Province __________________________
Country _______________________________
Zip/Postal Code _________________________
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Thank you for ordering from Feathered Frog Essentials. If you have any questions, please do not hesitate to contact us by phone at: 778-437-3040, or by email at: featheredfrog@eastlink.ca
