Printable Mail Order Form

Starving Farmer Popcorn Mail Order Form

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USPS Shipping Info:                                                   

Name:_____________________________________          Phone:________________________    

Address:___________________________________           E-Mail:________________________

City & State: _________________________________          Discount Code:________________________

 Zip Code:    _________________________________

Japanese White Hulless Popcorn

                                      Selection                   Price          Plus            Shipping              Total

1 - 2 pound bag_____________               $6.95            +               $10.85       =       $17.80

2 - 2 pound bags____________               $13.50          +               $10.85       =       $24.35

4 - 2 pound bags____________               $26.00          +               $10.85       =       $36.85

6 - 2 pound bags____________               $36.00           +             $10.85        =       $46.85   

8 - 2 pound bags____________               $44.00           +              $10.85       =       $54.85

12 - 2 pound bags____________             $64.00          +               $10.85       =       $74.85

Christmas Japanese White Hulless Popcorn

6 - 1 pound bags____________               $24.00          +                $10.85       =       $34.85

12 - 1 pound bags____________             $40.00          +                $10.85       =       $50.85

Movie Theatre Popcorn

1 - 2 pound bag_____________               $6.00            +               $10.85       =        $16.85

2 - 2 pound bags____________               $11.50            +             $10.85       =        $22.35

4 - 2 pound bags____________               $22.00          +               $10.85       =        $32.85

6 - 2 pound bags____________               $31.50          +               $10.85       =        $42.35

8 - 2 pound bags____________               $40.00           +              $10.85       =        $50.85

12 - 2 pound bags____________             $61.00          +               $10.85       =        $71.85

Mushroom Popcorn

1 - 2 pound bag_____________               $6.50            +               $10.85       =        $17.35

2 - 2 pound bags____________               $12.50            +             $10.85       =        $23.35

4 - 2 pound bags____________               $25.00          +               $10.85       =        $35.85

6 - 2 pound bags____________               $35.50          +               $10.85       =        $46.35

8 - 2 pound bags____________               $42.00           +              $10.85       =        $52.85

12 - 2 pound bags____________             $64.00          +               $10.85       =        $74.85

Total for Order---------------------------------------------------------------------------      =                _____________

Send Order Form and Payment by Personal Check or Money Order To:

Greg Richardson

Starving Farmer Popcorn LLC

5587 Rd. U.5 NW

Quincy, WA 98848