The Maple Leaf Natural Health Store                                 Order Form
1296 N Highland Ave #2
Jackson, TN. 38301

Phone 731-427-6306
Easiest way to order JUST CALL!!

Disclaimer   Home

Description & Brand Bottle Count Quantity Price
Subtotal     $
Shipping & Handling $ 5.00 $
All orders shipped with in 48 hours with the exception of Friday orders which will go out Monday Morning. For special shipping requirements please call for price. All orders sent United States Postal Service Priority Mail.
Taxes: Tennessee add 9.75% Sales Tax $
Total $
State: Zip:
Telephone Email Address:
Credit Card Orders: I will Process your order by email for the products, but for the safety of your card number I will call you when I have pulled your order to process your Credit Card. If faxing order fill in credit card information below.
               -          -          -                     Expiration Date       /               

Three digit security code on back of card           -       -    

No Checks. American Money Orders Only
Print This Form & Fax 731-427-6304 or Email or mail to address above with a money order.