FRESH ROAST COFFEE ROASTERS

P.O. Box 374

Kingfield ME 04947
ORDER FORM
For purchases of roasters and parts with Money Order and Personal Check Payments Only.
Name: ____________________________________________Date:______________
Shipping Address: _____________________________________________________
City or Town: ______________________State or Province: _____________________
Country: __________________________Mailing Code: ________________________

To Confirm Receipt of Your Order:

Email Address: ________________________________________________________

To Confirm Accuracy of Your Shipping Address, if necessary:

Your Telephone Number: _________________________Mobile: __________________

Your Order:
Item:_____________________________________Price: ________________
Item:_____________________________________Price: ________________
Item:_____________________________________Price: ________________
Total: ________________
Print this form and complete. Make Money Orders and Checks payable to FRESH
ROAST; and mail to FRESH ROAST, P.O. Box 374, Kingfield ME 04947. The above
information will be held privately and securely, and will never be shared. Thank you
so much. Your order with be expedited as quickly as possible; and will be shipped as
soon as your funds are cleared.