Miller Hatcheries Email Order Form

This form is a text form that you can fill out with your computer. Here's how to do it: (1) Open the file it will automatically open in Microsoft Word (2) Fill it out (3) Save the Order to your computer (remember where you file it) (4) Attach the order to the email you are sending to Miller Hatcheries at sales@millerhatcheries.com.

Date

Contact Name

Company

Phone

Mailing Address


Postal Code:   Date Required:

Shipping Instructions

Call at Hatchery Trucking Company Air Cargo Air Mail

Message

Phone:

Products - Link to Price List

 

Quantity

Breed or Description

Sex

Price

Amount

Sub-Total

Special Services - Maximum of 10 Brooding days. We cannot ship medications - immunization occurs on site.

 

Quantity

Service

Price Per Chick/per Day

Brooding
Days

Amount

Sub-Total

 

Total Charges and Payment Information

Freight or Parcel Post Charges

GST applies to Postal charges, supplies & services only

GST

If breed is not available, my second choice is:

Total Amount

Have you order Champion Chicks or Poults before?
Yes  No  Year?

Deposit - Amount Paid

Method of Payment:   Visa  MasterCard  Cheque  Cash

Balance to Pay