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Place an Order

Your Name

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(first) (last)

Your Address

____________ ___________
(number) (street)

____________ _____ _____
(city) (State) (Zip)

Credit Card

________________________
(Number)

____________ ___________
(Name-Visa/MC etc.) (expire date)

Your Phone #

________________________

Signature

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SUB TOTAL

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Virginia Residents add 4.5%

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UPS COD fee-$5.00

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Shipping
(Call for quote if not noted)

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TOTAL

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Print this form and fax or send this order to:

Ennis Mountain Woods, Inc.

292 Woodpecker Way
Afton, Virginia 22920
Voice: 540-456-8215
Fax: 540-456-7209
Internet: www.ennismountain.com
E-mail: dhbailey@netzero.net

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