Garden Harvest, Inc.
Adopt a Goat Mail In Form
Fighting Hunger and Saving Lives
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Please fill out the order form below, and include your information: Your billing information, payment information, and, if a gift, the recipient, date you'd wish it to be sent, how you would like it sent, and any personal message you would like added to the Goat Adoption Certificate. The Goat Adoption Certificate can take a message up to 3 short lines.. |
| Quantity | Description | Amt. Each | Total Amount |
| One Year Goat Adoption | 50.00 | ||
| Two Year Goat Adoption | 100.00 | ||
| Lifetime Goat Adoption | 500.00 | ||
| Certificate, Photo, Biographical Info sent by Email | 0.00 | ||
| Certificate, Photo, Biographical Info sent through the postal service | 5.00 | ||
| Total Order | $ |
| Please fill out your payment information below & Please PRINT clearly: |
| Name (as it appears on your credit card or check): ________________________________________ |
| Address: ____________________________________________________________________ |
| City, State, Zip Code: ___________________________________________________________ |
| Email:_______________________Phone: ___________________(if we have questions about your order) |
| I am enclosing payment by: Visa___MasterCard___Discover___Check*____ |
| Credit Card #:______________________________________________Expiration Date_________ |
| *Please make checks out to: Garden Harvest, Inc. |
| Mail to: Garden Harvest, Inc., 14045 Mantua Mill Rd., Reisterstown, MD 21136 |
| If this will be a gift to another, please fill in information below: |
| Name: ___________________________________________________________ |
| Address: ________________________________________________________ |
| City, State, Zip, Country: _____________________________________________ |
| Email: __________________________________________________________ |
| Date you wish the materials sent: _____________________________________ |
| Personal Message: ________________________________________________ |