Hillbilly Custom Rifles Order Form

Print this form and mail to
18 Clay Ridge RD
Milton, VT 05468

First & Last Name:  
Address:  
Address cont:  
Address cont:  
Day time phone #:  
Evening phone #:  
E-mail:  

Model: Select: Timber Line $3500 / Mountain Man $3300 / Dog Town $3300
Caliber:  
Barrel length:  
Metal finish:  
Stock color:  
Length of pull:  

Available options. Indicate options desired.
Muzzle break + $175.00  
Fluted barrel + $300.00  
Skeletonized bolt handle + $75.00  
Spiral fluted bolt + $150.00  
Three position safety + $275.00  
Total Cost:  

Payment:
Credit Card  
Name on card  
Card Number  
Expiration Date  
Address if different from above  
Money Order or Check Enclosed: Yes / No

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