Print this form and mail to:
Black Hills Area Council, BSA
Crazy Horse Lodge #171
144 North Street
Rapid City, SD 57709
605-342-2824
Fax 605-342-2826
bhac@rushmore.com
| NAME: | _______________________________________________ |
| ADDRESS: | _______________________________________________ |
| CITY, STATE, ZIP: | _______________________________________________ |
| PHONE: | _______________________________________________ |
| E-MAIL ADDRESS: | _______________________________________________ |
| Quantity | Item Ordered | Total |
| ______ ______ ______ ______ ______ |
_____________ _____________ _____________ _____________ _____________ |
|
| email
for details re:shipping + tax amounts |
Shipping Cost |
$_____________ $_____________ |
| Total Price | $_____________ |
| E-mail the Council | E-mail the OA Lodge |