Metal and Wood Order Form

Order Form
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Name ______________________________________________

Address ____________________________________________

City ________________________ State _____ ZIP ________

Phone ____________________ Fax ____________________

EMail ______________________________________________

Mail or Fax to:
Stephen R. Heilmann
PO Box 657
Grass Valley, CA 95945
Phone: 530-272-8758
Fax: 530-274-0285
EMail: sheilmann@sbcglobal.net

Wood Type: California English Walnut Bastogne Walnut

Cut: Quarter Sawn Slab Sawn Quarter to Slab

Color: Light Medium Dark High Contrast

Figure: Straight Grain Fiddleback Feather Crotch Marble

Type of Firearm to be Stocked

Bolt Rifle Single Shot Rifle Pistol Grip Shotgun Straight Grip Shotgun

Any Unusual Dimensions ____________________________________

Is this wood for immediate use? __________ Future use? ___________

Will you accept any knots, defects, sap or imperfect lay out in exchange for a fancier figured piece of wood at a plainer grade price? _______________

Other Comments

_________________________________________________________________________________

_________________________________________________________________________________

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	Qty.	Price
Stock Blanks - Price Range ________ to ________ (add $20 shipping per blank)

Custom Rifle color brochure, price list, more wood info: $7.50
California residents add 7.375% sales tax
Total:

Check Money Order Visa Mastercard American Express Discover

Card# _____________________________ Exp. Date ____________

Name on Card ___________________________________________

Signature ______________________________________________