PRINT THIS ORDER FORM AND MAIL WITH PAYMENT INFORMATION TO:

HippieDog Primitives
1429 N 3455 W
Clinton, Utah 84015

Phone #: 801-776-7089
Email: hippiedog@comcast.net

Circle Payment Method:          Check    Money Order            

  Print Name:
  Address:   Email:
  City:    
  State & Zip:    
  Telephone:   Signature:_____________________

Item Name and Description

Quantity

Price
     
     
     
     
     
     
     
     
     
     
     
     
     
 
    

Subtotal:  

    

Shipping and Handling:  

    
Utah residents must add 6.5% sales tax-   
    

MAKE CHECKS PAYABLE TO: Michelle Parent  

Total :

 


Thank you for shopping with HippieDog!!!