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Ship To:

Name
Address
Address 2
City
State
ZipCode
Phone
Fax
Email Address

Fill in the form, print and mail with payment or fax with payment information to:

Habitat for Humanity
of Fond du Lac County
88 South Portland Street
Suite 213
Fond du Lac, WI 54935
(920) 921-6623 - Phone
(920) 921-2893 - Fax
habitatfdl@dotnet.com
Item Name/Description Size QTY Price Each Total
$
$
$
$
Sub Total
$
Shipping
 $
Order Total
$
Enclosed is my Check or Money Order Made Payable to:
Habitat for Humanity, FDL Chapter
 Birdhouses cannot be shipped at this time. Please contact Habitat for pick-up information.

Please Bill My Credit Card
Name on Card
Credit Card Type
16 Digit Credit Card Number
Expiration Date (MM/YYYY)

 

Shipping and Handling Charges
1 Item - $5.00
2 Items - $8.00
3 Items - $12.00
4 Items - $15.00
More then 4 -
Contact Habitat for shipping costs.