BLUE RIDGE PARKWAY: Merchandise Order Form

SHIPPING INFORMATION:

Name ________________________________________________________
Address ______________________________________________________
City __________________________ State _________ Zip _____________
Phone No. (daytime) _______________________

Subtotal ______________

Tax ______________
(NC residents add 6%)

Postage/Handling ______________

TOTAL ENCLOSED ______________

Postage/Handling
$00.75 - $20.00 . . . . $4.50 | $20.01 - $40.00 . . . . $5.50
$40.01 - $60.00 . . . . $6.50 | $60.01 and over . . . . $7.50

Method of Payment:
Check, Money order, or Credit card (circle one)

VISA . . . MASTERCARD . . . AMER EX . . . DISCOVER

Credit Card Number _________________________ Exp. Date ____________

Signature (required) ________________________________________

Send Order to:
Eastern National, 210 Riceville Rd, Asheville, NC 28805
(828) 299-3507