Copyright © 2007 Shiitake Ya™

For other payment types, please indicate the quantity of the product you want, and fill in the following forms completely.

Select from the following products:

QTY	Description	Amount	Price
case(s)	Kowa™ Whole Dried Forest Shiitake	1 case    < minimum 1 case > (containing 12 jars, each jar is 12 oz)	$120.00 + shipping
case(s)	Mangia™ Sliced Dried Porcini	1 case    < minimum 1 case > (containing 12 jars, each jar is 7 oz)	$130.00 + shipping
jar(s)	Shiitake-Ya™ Four Mushroom Gourmet Salad	1 jar    < minimum 2 jars > (34 oz / jar)	$10.00 + shipping
case(s)	Shiitake-Ya™ Shiitake Slices	1 case    < minimum 1 case > (containing 8 bags, each bag 1 pound)	$120.00 + shipping

Your Contact:

* First Name:
* Last Name:
* Email:
* Phone:

Shipping Address:

* Address:
(not PO BOX)
* City:
* State:
* ZIP code:
Promotion Code

* Payment Options:

Check / Money Order
Credit Card / Paypal

*Required Fields



Note:

1) The prices listed above are not including your shipping cost.

2) We don't process your order if your information on this form is incomplete except promotion code.

3) Upon your submitting, we will send you an email with your Purchase Order# and the shipping cost as the confirmation of this order. Please follow the instructions to submit your payment immediately, as we won't ship out your order until we receive your payment. Please make sure you enter your email so we can send youa confirmation email.

4) If you are paying with a credit card, we will send you an email invoice using PayPal. However, you are not required to have a PayPal account to pay.