Minnetonka-by-Internet Printable Order Form

Please print this form

Mail and Fax Order Blank

How to order:
1. Fill in the order blank as indicated.
2. Order the same size moccasin as regular shoe size. Some styles are not made in half sizes. In this case, order the next full size.
3. Include Check, Money Order, or Credit Card Information. No COD's.
We will pay the postage on 4 pair or more. Otherwise add a one time per order charge of $7.50 to cover the cost of postage and handling.
4. Mail or Fax to:
Seguin's House of Cheese, Highway 41, Marinette, WI 54143, Fax: 1-715-735-3824

Billing Information
NAME _______________________________________
EMAIL _______________________________________
STREET______________________________________
CITY ___________________STATE ____ ZIP ________
PHONE ______________________

Gift Information
NAME _______________________________________
STREET _____________________________________
CITY __________________STATE ____ ZIP _________
PHONE ______________________

Qty.	Cat. No.	Description of Item	Size	Color	Price
x	x	x	x	x	x
x	x	x	x	x	x
x	x	x	x	x	x
x	x	x	x	x	x
x	x	x	x	x	x
x	x	x	x	x	x
Sub Total				x
Wisconsin residents add 5% sales tax				x
Postage and handling, under 4 pairs, add $7.50				x
Total amount enclosed				x

( ) Check ( ) Money Order ( ) Mastercard, ( )Visa, ( ) Discover ( ) American Express
Account Number __________________________ Exp. Date___________