Chemical Order Form

NAME___________________________________________________________________________________________

ADDRESS________________________________________________________________________________________

ADDRESS________________________________________________________________________________________

CITY________________________________________STATE_______________________ZIP___________________

PHONE________________________________________ FAX___________________________________________

CREDIT CARD_____________________________________________EXPIRE DATE______________________

Part Number Complete Units Quantity Price Total
ever10 Evercide 32oz   

$65.00

  
Vamp Vampire (formerly 7369 misting concentrate     

$248.60

    
PBO-8 PBO-8 Protector spray   $65.00   
Evercide Evercide Permethrin Protector and Mosquito spray   $65.00   
                                                     Shipping charges see below:
                                                                                      Total:
                                                     Shipping charges see below:        Free shipping
                                                                                      Total:

To place an order, please fill out this form and mail or FAX it to us at (605) 698-7596.  If you have any questions, please feel free to contact Stillson Fly Control at 1-800-332-3359.  Thank you for your order

STILLSON FLY CONTROL
P.O. BOX 134
SISSETON, SD 57262-0134
1-800-DEAD-FLY                             1800deadfly@sbtc.net
Shipping Table
Order Amount      Shipping & Handling Charge
$1 - $150      $11.50
$151 - $350      $20.00
$351 - $700      $37.00
$701 - $1400      $72.00
$1401 and over      We will call you

 
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