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Please use this order form only when mailing a check or money order with your order. For Pay Pal or credit card orders,
please use the "Buy It" buttons found after each item. They will take you to a shopping cart and secure site for on-line payment.
To e-mail us, please use the Contact Us page. Thank you!
 

Date:  
6155 Lower River Road
Grants Pass, Oregon 97526 USA
URL: http://www.hollyberrydairy.com

Ordered by:

First Name:    Last Name:   
Address:
City: State:       Zip:   
Country:
E-mail: Phone:   

Ship to (if different than above):

First Name:    Last Name:   
Address:
City: State:       Zip:   
Country:

Payment method: Check  #  Money Order   Cash
Refer to descriptions on Order Soap, Order Lotion, and Fragrance pages to select items & fragrances
Quan. Item Select Fragrance Total Price 
Shipping, handling, and insurance:  
  Total:
  Amount Enclosed:

Mail to: Holly Berry Dairy, 6155 Lower River Road, Grants Pass, Oregon 97526