Patches ‘n Planks 
1408 Chatham Road 
· Camp Hill, PA 17011
(717) 761-1509 · patchesnplanks@msn.com

Order Form   (Please Print Clearly and Send to Patches 'n Planks )

Sold To:Ship To:
Name: Name: 
Address:Address:
City:City:
State:State:
Zip:Zip:
Phone:Phone:
Email:Email:

 

QuantityBox #WoodDescriptionUnit PriceTotal
      
      
      
      
      
      
      
      
      
      

Shipping and Handling Charges

Total Merchandise 
0.01-35.00 = $12.9575.01 - 125.00 = $18.95PA Residents add 6% 
35.01 - 75.00 - $16.95125.01 - 175.00 = $22.95Shipping & Handling 
Over 175.00  - Call for prices. Total 

    Payment of Order (US Funds only)          

  • Check or Money Order
  • Visa
  • Mastercard

Card Number  __________________________    Expiration Date __________________

Signature ____________________________________   Thank You For Your Order.