http://www.AdirondackSource.com

The Adirondack Source: printable order form

Print this order form to mail or fax us your order
(To print: Select File, Print from your browser)

Mail to:
The Adirondack Source
3725 Walden Ave
Lancaster, NY 14086
Fax to:
1-716-675-7787

Phone orders: 1-716-662-6828


Name: ___________________________________________________________________

Address: _________________________________________________________________

City:____________________________________ State/Province:___________________

Zip:_______________ Country:______________________

E-mail: _________________________________________ Phone: (____)_____________

Today's date: _________________

Pay by (check one): [ ]Visa, [ ] MC, [ ] AmEx, [ ] Check, [ ] Money Order

Credit card number: ______________________________ Expiration date:____________

Name on the card: ________________________________________

ITEM DESCRIPTION QTY. PRICE TOTAL
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FREE SHIPPING 

FREE!.

NEW YORK RESIDENTS ADD 8.75% SALES TAX 

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  TOTAL AMOUNT 

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Mail to:
The Adirondack Source
3725 Walden Ave
Lancaster, NY 14086
Fax to:
1-716-675-7787
http://www.AdirondackSource.com