Ledge Haven Farm
Pure Vermont Maple Syrup
145 Mt. Independence Rd
Orwell, VT  05760
1-888-534-4286
1-802-948-2545
website: www.vtmaple.net

Order Form
To order: Send check, money order, or credit card info with the following information. Use the table below to figure shipping and handling prices. Call for pricing on multiple orders. Orders outside the US will be billed separately for shipping.

Container Grade Size Quantity Unit price  Total
           
           
         
           
           
           

Ledge Haven Farm
145 Mt. Independence Rd.
Orwell, VT  05760
Make checks payable to: Ledge Haven Farm

 Subtotal  
Shipping/Handling
(see below)		  
TOTAL   
(no sales tax)		  

Shipping and Handling
 

Gallon

1/2 Gallon

 Quart

Pints, all sizes glass and cabin cans

New England & NY

$10.00

$7.25

$5.90

$5.50

East of the Mississippi

$12.00

$8.50

$7.25

$6.90

West of the Mississippi

$14.00

$9.50

$8.10

$7.30

__MasterCard   __Visa   #________________   Expiration date ________

_______________________________________
                    Cardholder signature

Ship To:

Name:______________________________

Street:_______________________________(UPS will need street address not PO Box to deliver)

City:_________________ST:_________ZIP:_______

Thank you for your order. Enjoy!