Product Order Form
Orders will not be shipped until order form and payment have been received!

Make Checks Payable to:
Pony Express Riders of Iowa
and send order form to:
 Pony Express Riders of Iowa
Jeff & Lori Christiansen
2446 State Hwy. 2
Clarinda, IA 51632
 712-542-2174
Item Size Color Price Ea. Quantity Total
            
            
            
            
            
            
Additional Costs: Shipping (includes up to 3 items) -  $5.00 | Each Additional Item  - $ .75
Plus 6% Sales Tax
__________________ Grand Total

Shipping Information:

Name: __________________________________________________________

Street Address: ___________________________________________________

City: __________________________ State: __________ Zip: ______________

Phone: __________________________________________________________

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