4177 Riddle By-Pass Road, Riddle, Oregon, 97469
(541) 874-2137 ; FAX (541) 874-3107
C.V.V. Number on your Credit Card
|Visa, Master Card and Discover Cards:||Last 3 digits of the Card Number imprinted in the Signature Strip on the BACK of the card.|
|American Express:||4 digit number above and to the right of the Card Number on the FRONT of the card.|
Secure Online Order Form
If you do not wish to submit this form online, you may fax or send it by mail. Complete the form and print two copies. Retain a copy for your records. You may also print the blank form and complete it at a later date or call us direct at 541-874-2137.