BIGHORN BOTANICALS, INC.
25 Bighorn Lane Noxon, MT 59853 PH: 406-847-5597 FX: 406-847-5502
Toll Free: 888-847-1223 Email: nox5597@blackfoot.net
www.bighornbotanicals.com
RETAIL ORDER FORM
DATE: ____________________ PH: _______________________________FX: ____________________ Cell:___________________________________Email: ________________________________________
NAME: ______________________________________ REFERRED BY: _________________________
ADDRESS: ___________________________________________________________________________
VISA or MASTERCARD # _____________________________________________________________
EXP DATE: ________________CODE # __________________
Montana Specialty Tinctures
“Formula” indicates a multi-herb tincture. All others are single herb tinctures.
Natural ingredients sustainably wildcrafted or grown without chemicals in NW Montana.
QUANTITY________________________________________________________________TOTAL____ SYNERGY-7x FORMULA (Fresh 1:1.5) (Previously offered as Montana Cold/Flu Formula) __________2 oz bottle w/dropper ….………………………………………….@ 22.50 = ____________
__________4 oz bottle ………………………………………………………….@ 43.00 = ____________
__________16 oz bottle (1 pt) ……….……………….………………………..@ 160.00 = ____________
CANDIDA FORMULA (Fresh 1:2)
__________2 oz bottle w/dropper ……………………………………………..@ 24.50 = ____________
__________4 oz bottle ………………..………..……………………………….@ 47.00 = ____________
__________16 oz bottle (1 pt) …….…………………….…………………….. @ 160.00 = ___________
RESPIRATORY FORMULA (Fresh 1:1)
__________2 oz bottle w/ dropper …………………………………………….@ 22.50 = ____________
__________4 oz bottle ……………. …..……………………………………….@ 43.00 = ____________
__________16 oz bottle (1 pt)…………………………………………………..@ 160.00 = ____________
BLACK ELDERBERRY (Fresh 1:1) Sambucus nigra
__________1oz bottle w/dropper………………………………………………@ 11.00 = ____________
__________4 oz bottle ……………….…………………………………............@ 39.00 = ____________
__________16 oz bottle (1 pt)……….………………………………………….@ 140.00 = ____________
DEVIL’S CLUB STEM w/BARK (Fresh 1:2) Oplopanax horridus
__________1 oz w/dropper… ……….…………………………………………@ 9.50 = ____________
__________4 oz bottle …………………………………………………….........@ 36.00 = ____________
__________16 oz bottle (1 pt)..…………………………………………………@ 140.00 = ____________
Shipping _______________
SHIPPED: ___________________CARRIER:________________ TOTAL $ ________________
(Office use only: PTS ___________PTI ____________________ )
RETAIL ORDER FORM
DATE: ________________________ PH: _____________________FX: __________________
Cell: ____________________________Email: _______________________________________
NAME: _______________________________________REFERRED BY: ________________
ADDRESS:____________________________________________________________________
VISA 0r MASTERCARD # ______________________________________________________
EXP DATE: _________________CODE:____________________
Montana Specialty Tinctures & Salves - page 2
QUANTITY TOTAL
ECHINACEA FLOWER TOP (Fresh 1:2) Echinacea purpurea
_____________1 oz bottle w/dropper ……………………………………………………………...@ 9.50 = ______________
_____________4 oz bottle …………………………………………………………………………..@ 36.00 = ______________
_____________16 oz bottle (1 pt) …………………………………………………………………...@ 140.00 = ______________
LOMATIUM ROOT (Fresh 1:2) Lomatium dissectum
_____________1 oz bottle w/dropper ……………………………………………………………….@ 9.50 = _______________
_____________4 oz bottle…………………………………………………………………………….@ 36.00 = _______________
_____________16 oz bottle (1 pt) ………………………………………………………………….. @140.00 = _______________
RED ALDER CATKINS (Fresh 1:1) Alnus rubra
_____________1 oz bottle w/dropper ……………………………………………………………….@ 9.50 = _______________
_____________4 oz bottle …………………………………………………………………………...@ 36.00 = _______________
_____________16 oz bottle (1 pt) …………………………………………………………………..@ 140.00= _______________
ST. JOHN’S WORT FLOWER TOP (Fresh 1:1) Hypericum perforatum
_____________1 oz bottle w/dropper ……………………………………………………………… @ 9.50 = _______________
_____________4 oz bottle ……………………………………………………………………………@ 36.00 = _______________
_____________16 oz bottle (1 pt) …………………………………………………………………. @ 140.00= _______________
WHITE BIRCH BARK (Dry 1:4) Betula alba
_____________1 oz bottle w/dropper ……………………………………………………………....@ 11.50 = _______________
_____________4 oz bottle …………………………………………………………………………...@ 44.00 = _______________
_____________16 oz bottle (1 pt) …………………………………………….................................@ 160.00 = ____________
WILD HUCKLEBERRY (Fresh 1:1) Vaccinium globulare
_____________1 oz bottle w/dropper ……………………………………………………………….@ 9.50 = _______________
_____________4 oz bottle ……………………………………………………………………………@ 36.00 = _______________
_____________16 oz bottle (1 pt) …………………………………………………………………..@ 140.00 = _______________
Montana Specialty Salves (ointments)
CANDIDA SALVE - external use only
_________ 1 oz ……………………………………………………………….@ 17.00 = ______________
WHITE BIRCH BARK SALVE– external use only
_________1 oz ………………………………………………………………...@ 12.50 = ______________
SUB-TOTAL $________________
PRODUCT INFORMATION ON BACK Shipping ________________
TOTAL $ _______________
SHIPPED: ___________________CARRIER: _______________
Office use only: PTS _____________ PTI ________________________
BIGHORN BOTANICALS, INC.
25 Bighorn Lane Noxon, MT 59853 PH: 406-847-5597 FX: 406-847-5502
Toll Free: 888-847-1223 Email: nox5597@blackfoot.net
www.bighornbotanicals.com
RETAIL ORDER FORM
DATE: ______________________ PH: _____________________________FX: __________________
Cell: __________________________________ Email: _______________________________________
NAME: _______________________________________ REFERRED BY: _______________________
ADDRESS: __________________________________________________________________________
CONTACT PERSON: ______________________________ REFERRED BY:____________________
VISA or MASTERCARD # ___________________________________________________________
EXP DATE:_________________CODE # ________________
Montana Herb Tea Bags
Herb teas have been used for centuries to boost the immune system, relieve stress, improve digestion, combat inflammation and promote sleep. BLENDS contain more than one herb. SINGLES contain one herb. All are made with fresh herbs, sustainably harvested from the wild or farmed without chemicals in NW Montana. Zip-loc, re-sealable food-grade packaging, protected from light & air.
QUANTITY ___ TOTAL
ECHINACEA with a hint of Mint (Blend – multi-herb)
__________ Pkt of 24 bags ……………………………………………@ 8.50 = ___________
CANDIDA (Blend - multi-herb)
__________ Pkt of 24 bags ……………………………………………@ 10.50 = ___________
RESPIRATORY (Blend - multi-herb)
__________ Pkt of 24 bags……………………………………………. @ 10.50 = ___________
HAWTHORN BERRY – (Single - Crataegus columbiana)
__________ Pkt of 24 bags …………………………………………….@ 8.50 = ___________
HORSETAIL – (Single - Equisetum arvense)
__________ Pkt of 24 bags …………………………………………… @ 8.50 = ___________
NETTLE LEAF – (Single - Urtica dioica)
__________ Pkt of 24 bags …………………………………………… @ 8.50 = ___________
SPEARMINT LEAF – (Single - Mentha spicata)
__________ Pkt of 24 bags ……………………………………………..@ 8.50 = ___________
SUB-TOTAL $ _________________
PRODUCT INFORMATION ON BACK Shipping _________________
SHIPPED: __________________CARRIER:_________________ TOTAL $ _________________
(Office use only: PTS ___________ PTI ____________________) |