Click to Print Form

Name :                                                                                                                                                                              

Address :                                                                                                                              

City:                                                          State:                            Zip:                            

Phone:                -               -                      

Our Catalog's Items (item number), (Sizes - Colors): Price
     Buck Tan Leather (#RCBT) (Sizes: 19", 21" 23", 25"  Color: Tan): $25.00
     Latigo Leather (#RCL) (Sizes: 21", 23"  Colors: Black): $25.00
     Oak Tanned Leather (#RCOT) (Sizes: 22"  Colors: Red, Green, Blue, Light Tan): $25.00
     Reflective Buck Tan (#RCLR) Leather  (Sizes: 19", 21" 23", 25"  Color: Tan with Blaze): $25.00
     Synthetic Reflective (#RCSR) (Sizes: 19", 21" 23", 25" Color: Blaze with reflective center): $25.00
     Gift Certificate (#RCGC) - Please specify recipient's name: $30.00 (includes gift shipping costs)

Domestic US Shipping/handling is $5.00 for the first collar. $3.00 for each additional collar shipped to
one address. Outside of the domestic US, please contact us regarding shipping/handling costs before
placing your order.

ORDER FORM:       

Item #

Item Name/Description

Qty

Price

       
       
       
       
       
       

Subtotal

 

$5.00 for Standard Shipping (U.S.) for first collar.
Add $3.00 for each additional collar to be shipped to the same address.
 

TOTAL BALANCE DUE

 

If item is a gift, please note recipient's name and address: 

 

Please note: Orders funded with personal checks will not be shipped prior to check clearing. Orders paid
via money order will be immediately processed.

Please make checks or money orders out to ROUX COLLARS and mail them to:

Roux Collars, 115 North Roclay Drive, Lafayette, LA  70506
Telephone: (337) 984-4339    Email: rouxcollars@gmail.com

Roux Collars Web SiteŠ design and creation by WebbedPause.com, 2006.