Order Information
Phone: (888) 472-4673
Fax:   Print this form and fax it to (530) 367-6640
Mail:  Send this form to Bechhold & Son Flasher & Lure Co., PO Box 967, Foresthill, CA, 95631

Online: Complete this form and click on “SUBMIT” at the bottom.

Shipping Information
SHIPPING INCLUDED FOR ALL ORDERS shipped inside the United States
(We ship priority US Mail)

Please include the following information when you order.

“Product Field”

Brief description of item

Product	Item #	Description	Price	Qty.	Total
			Subtotal
			Shipping
			Total

Shipping Address

Name *
Address *
City *		State *
Country		Zip
Phone *
Email *

* required

Billing Address
  Check if same as shipping address

Name
Address
City		State
Country		Zip
Email

Billing Information

Credit card
Name on Card
Card number **
Expiration

** For security, please feel free to call us with your credit card information if you prefer.