Quiet Creek Herb Farm, 93 Quiet Creek Lane, Brookville, PA 15825. Thank You!

Quiet Creek Herb Farm Order Form: Print this form, fill it out and mail order form and check or money order to:

Quiet Creek Herb Farm, 93 Quiet Creek Lane, Brookville, PA 15825. Thank you!

Your Name______Your Full Address______

Your Phone Number______Your Email Address______

PRODUCT/TYPE/QUANTITY /PRICE /QUANTITY /TOTAL PRICE

SOAP: Lavender ___, Lavender Oatmeal___, Lavender Lemongrass___, Facial ___, Complexion ___, Rosemary, Chicken of the Woods Chaga ___, Pure___, Tea Tree ___, Rosemary ___, Rosemary Lemongrass ___, Patchouli Oatmeal ___, Peppermint ___, Peppermint Oatmeal___, Jewel Weed___, Pet Soap ___

# of bars ______X 5.25 per bar X 1.06 (tax) = Total Price $______

SALVES: Anti-Inflammatory ___, Antiseptic ___, Aphrodisiac ___, Arthritis ___ , Arnica ___, Cold Sore ___, Dry Skin ___, Eczema__, Gardening ___, Headache ___, Healing Salve ___, Insect Repellent ___, Insomnia ___, Lip Balm __,

Memory ___, Perineum ___, Sinus ___, Sore Salve ___, Shoe & Skin ___, Tick Repellent ___.

# of bottles ______X 5.25 per bottle X 1.06 (tax) = Total Price $______

ESSENTIAL OILS: Basil __, Bergamot, ___, Cedarwood ___, Cinnamon ___, Citronella ___, Clove ___, Coriander ___, Eucalyptus ____, Fir Needle ____, Frankincense ___, Geranium ___, Grapefruit ___, Lavender ___, Lemon ___,

Lemon Grass ___, Orange ___, Oregano ___, Patchouli ___, Peppermint ___, Rosemary ___, Sage ___, Tangerine ___,

Tea Tree ___, Ylang Ylang ___.

# of bottles ______X 7.00 per bottle X 1.06 (tax) = Total Price $______

SEASONING MIXES: Herb Butter ___, Herbs de Provence___, Herb Dip___, Italian Seasoning___, Jerk Seasoning ___, Lemon Shake ____, Meatloaf ___, No Salt Herb Shake___, Oriental Stir-fry ___, Poultry ___, Ranch Salad Dressing ___.

LOOSE TEA: Cold & Flu ___, Chai ___, Dr. Feel Good ___, Flower ___, Gingersnap ____, Kids Tea ___, Laryngitis ___, Lemon ___, Love ___, Memory___, Mint Medley __, Soothing Nerve ____ Second Breath ___, Snooze ___, Women’s __

CULINARY/MEDICINAL HERBS: Basil___, Bay Leaves ___, Calendula___, Catnip ___, Chamomile ___, Chives___, Comfrey___, Coriander ___, Cumin___, Hibiscus ___, Dill ___, Ginger___, Hops ___, Lavender ___, Lemon Grass _oos_, Lemon Verbena ____, Mountain Mint ___, Oregano ___, Peppermint ___, Raspberry Leaf ___, Red Clover ___, Sage ___, Stevia_oos__, Thyme ___, Winter Savory _oos__.

# of cups ______X 5.25 per cup = Total Price $______

MISC: Almond Oil 4 oz. : $4.75 ___, X 1.06 (tax) = Total $ ______

SHIITAKE MUSHROOMS: Caps___, Powder___, Slices___

# of containers______X $15.00 per container = Total Price $______

BOOKS BY RUSTY ORNER: SOAP___, GROWING SHIITAKE IN WESTERN PENNSYLVANIA___,

# of books______X $8.00 per book X 1.06 (tax) = Total Price$______

SHIPPING - $8.00 PER @25.00 ORDER/ $16 SHIPPNG ORDERS OVER $25.OO

TOTAL AMOUNT______

Print this form, fill it out and mail order form and check or money order to:

Quiet Creek Herb Farm, 93 Quiet Creek Lane, Brookville, PA 15825. Thank you!