Rosebud Chukar Farms
ROSEBUD CHUKAR FARM: CHUKAR EGGS - ORDER FORM
Owner: Mike Sammon
140 Loop 265
Rosebud, TX 76570
Phone: (254) 583-4306 Nights
Phone: (254) 721-1481
FAX: (254) 583-9041
E-mail: rosebudchu@aol.com

EGGS ARE NORMALLY SHIPPED PRIORITY MAIL THROUGH THE POST OFFICE UNLESS NOTED HERE:____________________________________________________

NAME______________________________DATE_______________
ROUTE_____________________________ BOX____________________________ PHONE(___)___________________
STREET ADDRESS_______________________________ CITY_______________________________
STATE_______________________________ ZIP CODE_____________
E-MAIL ADDRESS___________________________________________

Number of Eggs_____X Price per egg________= Total________
DISCOUNTS: December 3 cents; January 2 cents and February 1 cent (Discount X eggs ordered) ___-_________
Total enclosed _____________ At PayPal site choose
Send Money and send
payment to rosebudchu@aol.com