Country Comfort Candle & Gift~Printable Order Form
Print this form for easy mail order. Complete your order, send along with your
check or money order *made payable to Country Comfort Candle & Gift* to:
Country Comfort Candle & Gift
Rt. 3 Box 41A
Aurora, MO 65605
Phone: (417) 723-9220
QTY PRODUCT NAME PRICE TOTALS
    $ $ 
    $ $ 
    $ $ 
    $ $ 
    $ $ 
    $ $ 
    $ $ 
    $ $ 
    $ $ 
MO Residents Add   5% tax -                              
Shipping and Handling :All items will be sent via USPS. If you would like shipped another way please let me know.

Shipping & Handling $
TOTAL ORDER  
CREDIT CARD INFORMATION
Name on Card -
Card Number -
Exp.date                   Circle One:  VISA        M/C
CUSTOMER INFORMATION
Customer Name
Address
City                                                           State                      Zip Code
Home Phone #                                Work Phone #                                    Email Address


Shipping Information: All items are shipped via USPS. To know exactly how much your shipping charges will be you will receive confirmation from us on your total order and we will weigh and calculate shipping which will be sent back in a confirmation e-mail. Orders will not be filled until receipt of payment.
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