Foxfire Packet Order Form
Please include this form when placing your order.     
 
I would like to order ______ number of Foxfire Packets at $60.00 each, 
plus $5.00 per packet for postage.

Name: ________________________________________________________

Address: ______________________________________________________

City: __________________________      State: ______      Zip: ___________

Phone Number: __________________________ (Including Area Code)     

Cell Phone: _________________________________ (Including Area Code)

Email:  ________________________________ (Optional for Foxfire Alerts)

(We respect your privacy.  No solicitation phone calls will be made, 
nor will your information be shared.)

Method of Payment (Please Check One):

*Check _____     AMEX _____     MC _____     VISA _____

*Make checks payable to The Foxfire Foundation

Credit Card #: __________________________________________________ 

Expiration Date: ___________ (MM/YYYY)

Signature: _____________________________________________________ 

A Foxfire bracelet will be sent for every 10 packets ordered.

Thank you for your kind purchase.  100% of each purchase is used to promote 
anti-drug information and education by The Foxfire Foundation.

Please Mail to:

The Foxfire Foundation
P.O. Box  #175732
Fort Mitchell, KY 41017