FLINT RIVER RANCH PRODUCT ORDER FORM Flint River Ranch Carol A. Stewart #FX32 Retail Price Product Code Amount Total $49.99 DOG40 ______ $_______ $27.99 DOG20 ______ $_______ $18.99 DOG10 ______ $_______ $49.99 NUG40 ______ $_______ $28.99 NUG20 ______ $_______ $49.99 SEN40 ______ $_______ $27.99 SEN20 ______ $_______ $18.99 SEN10 ______ $_______ $54.99 PLUS40 ______ $_______ $29.99 PLUS20 ______ $_______ $19.99 PLUS10 ______ $_______ $55.99 LMR40 ______ $_______ $29.99 LMR20 ______ $_______ $19.99 LMR10 ______ $_______ $56.99 FNC40 ______ $_______ $29.99 FNC20 ______ $_______ $19.99 FNC10 ______ $_______ $38.99 BON20 ______ $_______ $25.99 BON10 ______ $_______ $17.99 BON5 ______ $_______ $49.99 JW20 ______ $_______ $29.99 JW10 ______ $_______ $19.99 JW5 ______ $_______ $49.99 LMW20 ______ $_______ $49.99 TPW20 ______ $_______ $39.99 CAT20 ______ $_______ $19.99 CAT9 ______ $_______ $18.49 CAT6 ______ $_______ $19.00 LIT9 ______ ______ $17.99 DW48 ______ $_______ $39.99 DW9 ______ $_______ AUTHORIZATION FOR AUTOMATIC SHIPMENT:
I hereby authorize FLINT RIVER RANCH to automatically ship prepaid, the following product
order and request FLINT RIVER RANCH initiate debit entries to my credit card to effect any
payment owing me to FLINT RIVER RANCH . I understand to cancel this authorization requires
a minimum of 5 BUSINESS DAYS WRITTEN NOTICE to FLINT RIVER RANCH.
FAX (724)837-6003 OR PHONE (909)682-5048
1243 Columbia Avenue, B-6, Riverside, CA 92507-2123
Last:________________First: ___________MI:____FRR #:______
Address:__________________________________________________
City:__________________________State:____ Zip:____________
Phone: (D)(______)_____-________ (N)(______)_____-________
Payment by: Check____Visa____M/C____Amex____EFT_____
Card#_____________________________________________________
Expiration Date:________________
Cardholder Signature:___________________
Independent Distributor
Size /
Product
40 lb KIBBLE
Puppy and Adult
20 lb KIBBLE
Puppy/Adult Dog
10 lb KIBBLE
Puppy/Adult Dog
40 lb NUGGET
Size Dog
20 lb NUGGET
Size Dog
40 lb SENIOR
Kibble Dog
20 lb SENIOR
Kibble Dog
10 lb SENIOR
Kibble Dog
40 lb SENIOR Plus Adult Kibble Dog
20 lb SENIOR PLUS Adult Kibble Dog
10 lb SENIOR Plus Adult Kibble Dog
40 lb LAMB/MILLET/RICE
20 lb LAMB/MILLET/RICE
10 lb LAMB/MILLET/RICE
40 lb Trout & Sweet Potato
20 lb Trout & Sweet Potato
10 lb Trout & Sweet Potato
20 lb DOG BONE TREATS
10 lb DOG BONE TREATS
5 lb DOG BONE TREATS
20 lb JUBILEE WAFERS
10 lb JUBILEE WAFERS
5 lb JUBILEE WAFERS
20 lb Lamb Millet & Rice TREATS
20 lb Trout & Sweet Potato Wafer TREATS
20 lb Cat/Kitten
Food
9 lb Cat/Kitten Food
6 lb Cat/Kitten Food
***
9 lb
Adult Lite Cat Foot
48 oz (3lb) DryWater Ulta Fresh Dog Food
9lb DryWater Ulta Fresh Dog Food
Sub Total
__________
**PRICE INCLUDES DELIVERY**
Total
__________
CODE_______ AMOUNT_______ SHIP EVERY: 3 Weeks__ Month__ Other_________
CODE_______ AMOUNT_______ SHIP EVERY: 3 Weeks__ Month__ Other_________
Date: _____________ Cardholder's Signature:____________________________________
ESTIMATED DELIVERY TIME (Listed in BUSINESS DAYS):
West Coast: 3-5, Central: 5-8, Northeast/Southeast: 7-10
