P.O. Box 1984
Estes Park, CO  80517
Phone: (970) 586-5876
Fax: (970) 586-6685
Email: Office@SuriNetwork.org

SURI NETWORK ORDER FORM
(These prices are for members only; for non-members, the prices are two times the amount(s) shown).

Ordered By:

Ship To: Same
Farm Name Farm Name
Mailing Address Shipping Address
City City
State   Zip Code   State   Zip Code
Phone    
Email    

 

Description Cost Quantity Ordered
2001 PurelySuri Magazine $1.00  
2003 PurelySuri Magazine $1.00  
2005 PurelySuri Magazine $1.00  
2006 PurelySuri Herdsire Magazine $1.00  
2006 PurelySuri Fall Magazine $1.00  
2007 PurelySuri Herdsire Magazine $1.00  
2007 PurelySuri Fall Magazine $2.50  
Fliers $0.25  
Suri Network DVD 1 - $10.00 ea.
2-5 - $7.50 ea.
6+ - $6.00 ea.		  
Membership  Directory
(members only)		 $15.00  
Suri Network Mug $5.00  
Suri Network Wine Glass $5.00  
Suri Network Black Canvas Bag $20.00  

SHIPPING AND HANDLING CHARGES
will be added on and charged to your credit card

    TOTAL

  

METHOD OF PAYMENT

 Check    Credit Card Card Number    
VISA MC Expiration Date    
AMEX Name on Card    
  Security Code    

Credit Card Statement Address

Mailing Address
Shipping Address

    

Items shown in red are required.  If not submitting and paying by credit card,
please print and mail along with your check to the address shown above.  Thank you!