Order Form

Print & Mail Order Form to:

Herbs-on-Hudson
P.O. Box 342
Cornwall-on-Hudson
New York 12520

Name ________________________________________________________________

Street Address ________________________________________________________

City _______________________________ State ______ Zip Code _____________

Email Address _______________________________ Phone # _________________

Quantity

_____

Herb / Product

_____________________________________________________

Price

______

Shipping* ______

Total Cost _________

Visa/MC Number______________________________________________

Exp Date_________ Last 3 numbers on the back of card _____________

Signature ____________________________________________________

Please feel free to add additional pages as necessary to list the products you are ordering.

We accept checks (made payable to Herbs-on-Hudson) as well as Visa and Mastercard.

You can mail your completed form to the address above.

If there is a product or herb you did not see on our site, please
inquire. We can custom blend a formula for you.

*Shipping Costs

       Up to $60.00 - Add $6.00
$60.01 to $140.00 - Add $7.00
      up to $250.00 - Add $8.00
       Over $250.00 - No Charge