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1004 Tunnel Mountain Road - Sylva, NC 28779 

 Phone: (828) 586-6539       email: order@summermountain.com      Fax: (828) 586-0648
 
Please submit the form via US Mail or Fax. If you would prefer,
please feel free to call or email us.
When your order is ready to ship (usually within 48 hours),
you will be advised what the *shipping 
cost are, and the exact amount being charged to your credit card.
 
Thank You for shopping with Summer Mountain Herbals
 
Name __________________________________
Phone No. __________________________________
   
Fax No. _________________________
email _________________________
   
Shipping Address Cardholder Name and Billing Address (if different)
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Please check method of payment: Exp. Date______________________________
____MC  ____VISA  ____PayPal ____Check Signature______________________________
Card Number: ______ ______ ______ ______  

Product Description
 
Quantity
 
Unit Price
 
Extension
 
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Domestic Shipping: Please check one Subtotal _____________
___United Parcel Service (UPS)
 
___Parcel Post
 

 6.50% Tax
(NC Only)		  
_____________
*Shipping
(to be entered by SMH)
  
_____________
 Total (SMH will advise)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
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