Southern Grace Farms

Rt.1 Box 28A

Enigma, Ga 31749

FAX # 1(229)533-3058

ORDER FORM    PLEASE PRINT LEGIBLY!

 

Shipping Address:

 

Name:____________________________                                                        DATE:___________________________

 

Address:__________________________________                   Apt#/Suite# ___________________________________

 

City:_______________________________         State:__________         Zip:____________              Telephone:___________________

 

Email:________________________________________ (we will email confirmation/tracking number of your order)

 

CIRCLE ONE:  Residential Address or Commercial Address 

 

Item Name                                                          Size      Quantity             Price                                 Total Price

 ** Shipping will be figured after order is received.    **GA residents are subject to 7% sales tax. 

 If this item is a gift, please include a gift message with your order submission, as well as your billing address for your credit card!!

 

We accept checks, money orders, and credit cards

            MasterCard or Visa

 

Expiration Date:______________

 

Signature:___________________________________                            DATE:__________________________

*We must have exp. date and signature to process order.