PHONE/OR MAIL ORDER FORM
RIVERGEAR.NET
2948 Laguna Drive
Idaho Falls, Idaho 83404
Phone: 208-525-8345
phuebner@rivergear.net

Method of Payment:
_ Check or Money Order Enclosed (Sorry, no C.O.D.'s)
MasterCard/Visa#____________Date Exp.
Name:Signature:_

Ordered By:

Ship To:

(if different than left)
Name:

Name:

Address:

Address:

City:

City:

State:

State:

Zip:

Zip:

____________

Quantity
Item #
Description and Color
Price Each
Total

Idaho Sales Tax

Handling
Freight

Total

Shipping and Handling Charges (Order Totals):
$0.00 to $9.99 add $6.95
$10.00 to $49.99 add $8.95
$50.00 to $99.99 add $11.95
$100.00 to $199.99 add $13.95
$200.00 and over add $14.95
Next day and second day air available.