TO ORDER, PRINT OUT THIS FORM, FILL OUT COMPLETELY AND MAIL WITH YOUR CHECK OR MONEY ORDER TO:

LORI'S TACK
P.O. BOX 210513
NASHVILLE, TENNESSEE 37221-0513
Sold to:

Name:______________________________

Address:____________________________

City, State, Zip_______________________

Phone#:_____________________________

E-mail address:________________________

Ship to (if different than address at left):

Name:______________________________

Address:____________________________

City, State, Zip_______________________

Items not available for shipment will automatically be placed on backorder, unless you notify us differently. Back ordered items are normally available for shipment within 6-8 weeks. If you DO NOT want items placed on backorder, please check HERE _____.

ITEM NO. QTY ITEM DESCRIPTION SIZE FIRST COLOR CHOICE SECOND COLOR CHOICE ITEM PRICE TOTAL PRICE
               
               
               
               
               
               

Credit card number:

Expiration date:

Signature______________________________

GRAND TOTAL: __________

TN RESIDENTS ADD 8.25% SALES TAX: _____

(CLICK HERE FOR SHIPPING RATES)SHIPPING TOTAL_________

GRAND TOTAL_________

ADDITIONAL INFORMATION AND COMMENTS: