ORDER FORM
Please fill out the fields below, print a copy for yourself, then:
Mail to Outdoor Diversions dba WarmersCentral, 149 Eccles Dr, Hagaman NY 12086 *or*
Fax order to (518) 843-6907 *or* Phone order to (518) 843-6870 *or* Press Submit to email order
ORDERED BY
Name : Email:
Address:
City : ST : Zip : Phone :

SHIP TO (if different than Ordered by)
Name :
Address:
City : ST : Zip : Phone :

PRODUCT
Type Quantity
Choose Price
Type Total
G28 - Mini-Mini Hand Warmers
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RH8 - Adhesive Toe Warmers
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SW1 - Adhesive Warm Pack
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WP12 - 12 Hour Warm Pack
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WP30 - 20 Hour Warm Pack
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GBRA45 - Apple Raspberry
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GBAP45 - Apple Apricot
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GBST45 - Apple Strawberry
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GBWM45 - Wild Mountain Berry
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Energy Bars (2 of each flavor)
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(Shipping will be determined by UPS or USPS. Sales Tax may apply.)

Faxing or Mailing Your Order? Please fill out the following information by hand on your printout, before you send your order!___Visa ___MasterCard : Exp Date ___/___

CC# __ __ __ __-__ __ __ __-__ __ __ __-__ __ __ __

Card Holder Signature _____________________________

Thank You For Your Order!
You will be contacted shortly by Customer Service to confirm your order and arrange payment.