Twig Stove Order Form

To buy send $20.00 +$8.10 shipping and handling for each Twig Stove to (shipping is based on US postal rate and subject to change without notice)

Lester Shaw
3304 Beech Rd
Johnstown Oh 43031

We accept Check, Cash , Money Order, Discover, Visa, or Master Card.

Order by Phone with your Credit card. Toll Free In the USA 1-888-738-5337

Outside USA call 740-967-6147

Print this page fill out the information below and fax or mail it to us.

Shipping Information

Name_________________________________________________________________

Address_______________________________________________________________

City/State/Zip__________________________________________________________

Phone____________________________

(Circle one) Check Cash Money Order Discover Visa Master Card (Circle one)

Card # |__|__|__|__|-|__|__|__|__|-|__|__|__|__|-|__|__|__|__|

Zip Code credit card is billed to |__|__|__|__|__|

Expiration Date |__|__|-|__|__| (Like January 2001 = 03-01)

I authorize the withdraw of $__________ #of Twig Stoves Ordered_______

Authorization Signature_________________________________Date___________

Send to Lester Shaw 3304 Beech Rd Johnstown Oh 43031