Groomer/Breeder/Handler Discount Order Form
Please print this order form, fill out the information
Phone your order in to: PH: 828-396-9970 / Or Fax order form to: 828-396-9970
Mail with your Money Order, Certified Check, Personal or Business Check. Make check payable to Tammie Ford and mail to:
Pnderosa Products - 5791 Rocky Mount Rd., Granite Falls, NC 28630

Please submit a separate order form if additional items needed.
All merchandise shipping is held until personal or business checks have cleared.
Groomer/Breeder/Handler Discounts apply on all our Shampoo & Conditioner Blends
in the 16oz ($9.60), 32oz ($16.00), 1/2 Gallon ($28.00) & 1 Gallon size ($43.20) only. There is no Min. order requirement
Put Quantity desire beside each product size you wish to purchase.

(Example: Moisture Blend: 16oz:_2 X$9.60=$19.20   Gallon:_1_x$43.20=$43.20)

Shampoo

Silk Blend
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

Moisturizing Blend:
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

Volume Blend:
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

Puppy Silk Blend:
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

Puppy Volume Blend:
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

White Moisture Blend:
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

White Volume Blend:
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

White Puppy Silk Blend
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

White Puppy Volumen Blend:
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

Total Shampoo cost: $ ____________

Conditioner

Silk Blend
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

Moisturizing Blend:
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

Volume Blend:
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

Puppy Silk Blend:
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

Puppy Volume Blend:
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____    1/2 Gallon: __ x $28.00 = $______   Gallon: ____ x $43.20 = $_______

Silk Reflection Concentrate:
16oz : ___ x $9.60 = $_____     32oz: ___ x $16.00 = $_____      1/2Gallon____x$28.00

Total Conditioner cost: $ ____________

Total Merchandise Order: $_______

Shipping amount & Additonal Comments in applicable: $_____

Total Amount enclosed: (Please include shipping) $_____

Ship to: Mr.   Mrs.  Ms   Miss:

ADDRESS:

City:

STATE: ZIP:
Credit Card Information: ___Visa,  ___M/C,  ___Amex,  ___Discover Account #:
Exp.Date:         Code
  ___/___          ____
I authorize this order to be charged to my account by my signature. Name on Card: (Signature)

If we need to
contact you....

Telephone:
Fax:
e/mail:

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