Ordered By___________________________________________
Street_______________________________________________
City______________________________ State_____________
Zip______________ Phone______________________________
Ship to______________________________________________
C/O__________________________________________________
Street_______________________________________________
City______________________________ State_____________
Zip______________ Phone______________________________
Quantity Description Price Total
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Subtotal|_________|
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Michigan deliveries add 6% sales tax|_________|
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Shipping Charges (see chart below)|_________|
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Total Amount|_________|
Paid by: Check Money Order VISA AMEX Discover
Account Number___________________________________
Expiration Date__________________________________
Signature________________________________________
Shipping Information: UPS Insured Shipping and Handling
Items Under $10 $3.75 $61-80 $6.75
$10-30 $4.75 $81-100 $7.75
$31-60 $5.75 $101 & over $9.00
Thank you for your order!
Is this a gift?_____________
Message:____________________________________________________
____________________________________________________________
Mail Order to:
Inland Passage
Box 826
Leland, MI 49654
Inland Passage Home Page