Golden-Winged Warbler Initiative - National Wild Turkey Federation

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Name (please print)
PENNSYLVANIA
Spring 2013 Seed Subsidy Offer
Address (unable to ship to PO Boxes)
City
Daytime Phone MUST INCLUDE
State Super Fund program pays 50% cost of seed and shipping
Orders must be completed on this form and submitted to the address listed below by mailing,
faxing or scanning as attachment to email.
No Orders Will Be Taken By Phone.
Must provide member number. Forms without member number will NOT receive seed.
Only One Member Per Form Allowed.
To avoid duplications, submit your form once. (fax, email, or regular mail.) Do NOT send multiple times.
State Zip
Evening Phone
Cell Phone Email Address
Mail order form to:
National Wild Turkey Federation
Attn: Pennsylvania Seed Offer
PO Box 530
Edgefield, SC 29824
or please fax or email form:
Fax: 803-637-9180
Email: cpenner@nwtf.net
Scan form, add as attachment to email
Credit Card
Signature
Today’s Date
Member Number (MUST have in order to
process request. Number located under *****
on Turkey Country magazine & your NWTF
membership card)
0060292016010000 Longevity Clover Strut & Rut ® Item# Description
Sponsor members allowed TOTAL of 2 bags -
Regular members allowed 1 bag on subsidized price
Qty Subsidized
Price
Shipping Included
– 12# $34.00 ea
Non Subsidized - But at a Special Reduced Price with NO LIMIT on amount ordered
0060292017010000 Longevity Clover Strut & Rut ® – 12# $68.00 ea
Grand Total
Limited quantity - first come
first serve - while supplies last
Please do not tear or cut this form
– return entire form with all fields completed
Payment: oCheck # _______________ oMoney Order oVisa oMaster Card oDiscover oAm Exp
(Make payable to National Wild Turkey Federation)
panwtf.org
Total
Exp. Date
Source Code: PA SS 12
Winter 2013 Turkey Talk13