Hillbilly Custom Rifles Order Form
Print this form and mail to
18 Clay Ridge RD
Milton, VT 05468
| First & Last Name: |
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| Address: |
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| Address cont: |
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| Address cont: |
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| Day time phone #: |
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| Evening phone #: |
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| E-mail: |
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| Model: |
Select: Timber Line $3500 / Mountain Man
$3300 / Dog Town $3300 |
| Caliber: |
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| Barrel length: |
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| Metal finish: |
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| Stock color: |
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| Length of pull: |
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Available options. Indicate options desired.
| Muzzle break + $175.00 |
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| Fluted barrel + $300.00 |
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| Skeletonized bolt handle + $75.00 |
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| Spiral fluted bolt + $150.00 |
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| Three position safety + $275.00 |
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| Total Cost: |
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Payment:
| Credit Card |
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| Name on card |
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| Card Number |
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| Expiration Date |
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| Address if different from above |
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| Money Order or Check |
Enclosed: Yes / No |
Comments: