La Carreta P.O. Box 70 Dixon, New Mexico 87527 U.S.A.
Telephone: (505) 579-4358
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Customer Name: Recipient #1:
Address: Address:
City, State, Zip: City, State, Zip:
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Recipient #2 Recipient #3:
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ITEM
SIZE
PRICE
QUANTITY
TOTAL ORDER
Chile Verde Jelly
8oz
$7.50
 - -
Red Chile Jelly
8oz
$7.50
 - -
Wild Cherry Chile Jam
8oz
$7.50
 - -
Green Chile Lemon Marmalade
8oz
$7.50
 - -
Wild Mint Lemon Jelly
8oz
$7.50
 - -
Pure Apple Cider Syrup
8oz
$10
 - -
Mullein Tea
4oz
$4
 - -
Rose Hip Apple Cider Vinegar
5oz
$5
 - -
 
Subtotal
  
Prices effective: Jan 10, 2006
NM residents, add 5.6%
  
Date Of Order:___________
Shipping and Handling 20%
  
Make checks payable to La Carreta
Total Due