Oregon Motorcycle Parts Mail Order Form

Part # | Description | Price | Quantity | Total
Shipping | $8.00 for orders shipped to anywhere in the USA up to $75 and $12.50 for orders over $75 Shipping to Canada is $28.00 and $3 8.00 for shipping to outside of North America. Orders over $75 shipped outside of North America require insurance and this increases the shipping cost to $6 4.00 |  |  |
Total |  |

| Shipping Information (The shipping info can be filled in before printing) |
| Name |  |
| Street address |
| City |  |
| State |  |
| ZIP code |  |  |
| eMail address |  |  |
| Country (if outside USA) |  |

Use your browser print function to print this page. Fill it out and mail it along with
a cashiers check or money order to:
Anthony Weeks
150 SW Hill Dr.
POB 529
Willamina, Oregon 97396
Cashiers checks and money orders must be made out to Anthony Weeks

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