Fax , Mail Order Form
Fax:   Print this form and fax it to 925 556 9034
Mail:  Send this form with payment to:RedBush Tea Company
                       9110-B Alcosta Blvd San Ramon, Ca., 94583

Product #

                   Item Description

Price

Qty.

Total

Please add shipping charges from the table below (US only)

Shipping

$ 0.00 TO $9.99
add $ 4.65

  $ 30.00 TO 39.99
   add  $ 7.99

Subtotal

$10.00 TO $19.99
add $ 5.99

  $ 40.00 TO 59.99
   add  $ 8.89

Tax

$20.00 TO $29.99
add $ 6.99

  $ 60.00 TO 199.99
   add  $ 10.50

Total

 


Shipping Address

Name

Address

Address 1

          

City

 

State.

Country

Zip

Email

Phone #

Comments



Billing Address
  Check if same as shipping address

Name

Address

          

City

 

State

Country

Zip

Phone #

Fax

Email


Billing Information

Credit card

Name on Card

Card number

Expiration