INSTRUCTIONS: Print out this Order Form. Fill in your complete name, mailing address and daytime phone number in the provided space. Please print legibly! Enter your choices on the form. Add totals for all items. Orders must be paid in full. IL residents add 6.25% tax, include shipping charges - use chart below. Please, checks or money orders only in US dollars on a US bank. No wire transfers or foreign currency.
NAME:
ADDRESS:
CITY:                                                        STATE:                ZIP:
DAYTIME PHONE: (        )
email:

Make Checks Payable to:
Henry's Rabbit Ranch
1107 Historic Old Route 66
Staunton, IL
62088 - 4361
e-mail: route66@midwest.net

ORDER NUM ITEM QTY PRICE TOTAL
   MP01a MONTANA FOR PRESIDENT BUTTON/PIN 2 1/4"    $2.75   
   MP01b MONTANA FOR PRESIDENT BUTTON/PIN 1 "    $1.50   
   MP02a MONTANA FOR PRESIDENT MAGNET 2 1/4"    $3.00   
   MP02b MONTANA FOR PRESIDENT MAGNET 1 "    $1.75   
   MPDES2 MONTANA FOR PRESIDENT STICKER    $3.00   
   MP04reg

MONTANA FOR PRESIDENT TEE-SHIRT 
(circle applicable):   S   M   L   XL   $18.00 each

    $18.00   
   MP04xxlg MONTANA FOR PRESIDENT TEE-SHIRT     $20.00   
   MP05 MONTANA FOR PRESIDENT PACKAGE    $27.00   
   MP05xxlg MONTANA FOR PRESIDENT PACKAGE XXLarge    $29.00   
   RR01 SPOT THE RABBIT    $10.66   
   RR02 HARE IT IS PIN    $3.25   
   RR03 ROUTE 66 SHIELD WITH RABBIT PIN    $3.25   
   RR04 HARE IT IS MAGNET    $1.95   
   RR05 HARE IT IS PATCH    $2.25   
   RR06 MONTANA T-SHIRT  (circle applicable):   S   M   L   XL   $18.00 each  
          XXL  XXXL $20.00 each   XXXXL $21.00 each    XXXXXL $22.00 each (Grey)   		   $____.00   
   RR07 "HARE IT IS" HAT    $11.00   
   RR09 MONTANA COFFEE MUG    $5.66   
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
           

  

  
ORDER TOTAL: ADD: ORDER TOTAL:

ADD:
$        0 to $ 25.00 $ 9.20

$ 25.01

 to $ 40.00 $11.20
$ 40.01 to $ 55.00 $13.20 $ 55.01 to $ 75.00 $15.20
$ 75.01 to $ 95.00 $17.20 $ 95.01 to $155.00 $19.20
$155.01 to $175.00 $21.20 $175.01 + add 8% to subtotal

Foreign Orders please contact Henry's Rabbit Ranch first: route66@midwest.net

SUBTOTAL  
TAX
(IL Residents only add 6.25%)		  
SHIPPING
(see chart at left)		  
ORDER TOTAL