Name:  
Address:  
City/State/Zip  
Email:  
Mail To: Natures Elements
716 120th Ave.
Blaine, MN 55434
Qty
Product description
Weight
Price
Amount
         
         
         
         
         
         
         
         
         
Please attach separate page if needed

To determine shipping charge, add total weight of all products. There are 16 oz's in one pound.
For orders up to 1 pound, add $5.00
For orders 1-5 pounds, add $10.35
For orders over 5 pounds, add $15.00
Subtotal
$
Shipping
$
7.125% MN tax
$
Grand Total
$

Payment Method (Please check one)

  Money Order/Cashiers Check Orders will not be shipped until personal checks have cleared
  Personal Check Enclosed
Credit Card
Card Number
Expiration
CSV Code
  Visa      
  Mastercard      
  Discover      

Name of Cardholder (as it appears on card) _________________________
Daytime Phone _____________________
Authorized Cardholder Signature _________________________________