Please print this form, fill it out by hand, and fax it to our NEW FAX # at 503-843-0108 or mail it to the address above. Make checks payable to Treecycle . Don't hesitate to contact us if you have any problems filling out (or printing) this form. Printing works best with your browser set to a 12 point font; larger fonts may cause an inopportune page break.

ORDERED BY		SHIP TO (if different) - No PO boxes
Organization	_________________________	Organization	_________________________
Your Name	_________________________	Your Name	_________________________
Address	_________________________	Address	_________________________
City	_________________________	City	_________________________
State, Zip	_______________ _________	State, Zip	_______________ _________
Telephone	(_____) __________________	Telephone	(_____) __________________
Email Address	_________________________	RESIDENTIAL OR BUSINESS ADDRESS	_________________________
PAYMENT INFORMATION
Select one:	___Check/Money order	Account Name	________________________
	___Treecycle Account	Account Number	________________________
	___Visa   ___ MasterCard	Expiration(mm/yy)	________________________
	___ American Express	Signature	________________________

item #	qty	color	description	ship weight	unit price	total price
Quantity Discount 5 to 9 cases of anything - take 5% off your entire order 10+ cases of anything - take 10% off your entire order					subtotal
					discount
Please see our Ordering Information page for shipping and payment instructions. All prices are in US dollars, and all payment must be made in US dollars.			total shipping weight		subtotal
			total number of cartons		shipping charges
			TOTAL DUE

Return to Ordering page

Please note any SPECIAL INSTRUCTIONS below