Black Kat Herbals -- Order Form

P.O. BOX 271 SMITHVILLE, TN. 37166
(615) 597-1270 Phone
(615) 597-9430   Fax
e-mail   blackkat@dtccom.net
Please print out the order form below and
mail it with your "Black Kat" Order
to the address shown above.
Go to the next page to place an
order for "Ready Reserve" Products
Thank You.

NAME__________________________________________________________
DATE __________________________________________________________
ADDRESS_______________________________________________________
CITY/STATE__________________________________ZIP________________
PHONE (      )____________________________________________________

Quantity Item Description
Price Each

Total

______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

Sub-Total:
(TN. Residents add 7 1/2% Tax)
Shipping & handling:
(See Chart Below)
Total Due:   __________ __________ __________ __________

Shipping and Handling: up to $20.00 . . .     add $4.00
$20.01 to $50 . . .   add $6.00
$50.01 to $100 . . . add $8.00
over $100     10% OF TOTAL

CANADIAN ORDERS: Please add 20% for shipping and handling.
INTERNATIONAL ORDERS: Add 25% for shipping and handling.

Payment for orders shipped outside the U.S. must be in US funds via postal money transfer, American Express Money Order or Canadian postal money order.
PLEASE MAKE CHECKS PAYABLE TO:     SANDI WAKEFIELD

TO RECEIVE OUR NEW “EMERGENCY PREPAREDNESS/FOOD SUPPLIES CATALOG” PLEASE REMIT $3.00 TO THE ADDRESS ABOVE. Short & Long Term Emergency Preparedness Foods, 72-Hour Emergency Survival Kits, Be prepared for Earthquakes, Floods, Snowstorms, Tornados, Hurricanes! Insure your family’s survival thru common sense advance preparation! MasterCard, Visa, AmEx, Discover or Time-Payment Plans available only on our Ready Reserve Emergency Supplies All Other Products, Check or Money Order *We are an authorized Ready Reserve Dealer