VALLEY FARMS PRODUCT INFORMATION


Please place your order using the form below or contact us at adipocere2@yahoo.com!


 
 
 

Enter desired quantities in the box at left of descriptions.


Last name First name
Company
Address
City State
Zip
Country (if different from U.S.)

E-mail address (rqd.)
Home Phone
Work Phone
Fax Number
 
 

Returning Customer?: Yes No 
Would you like to receive the Email Version of Valley Farm's newsletter?  Yes No I already receive it

If you are not placing an order for merchandise, you may click on the "Send Form" button at the bottom of the page.

Payment Information

| Master Card | Visa| Discover | I prefer to send payment via check/money order |

Card Number: 
Expiration Date: 
Name as it appears on card: 
 

Billing address of credit card holder:

Address is the same as listed above 

Street address: 
City: State: 
Zip: 

Some customers may choose to  contact us via telephone to submit Credit Card information.


 
 

Having difficulty with Credit Card orders, check out this useful service complements of Valley Farms.
 

If you have difficulty processing  your order with this
form or if you have any questions or concerns
please contact us.

Main Page | On Line Order Form
Credit Card Links| Back to Spooky Martin |  Adipocere Links
Questions, Contact Us.











Copyright 2003, Valley Farms Inc/Adipocere.com.