Click File - Print to print this form.
Use the form to have order ready before calling
Phone: (866)561-2198 (Toll Free)

Or send by Snail mail to:
OLD GLORY FARM
115 6th Ave SW
BUFFALO CENTER, IOWA 50424


We accept Visa and Mastercard

e-mail: msgtret@wctatel.net
Please call to finalize the order.

Order Form
Billing Address:
Name:____________________________________________________________
Address:__________________________________________________________
City:______________________________________________________________
State:______________________________
Zip:____________
Daytime Phone:____________________
Evening Phone:____________________

Shipping Address:
Name:_____________________________________________________________
Address:___________________________________________________________
City:______________________________________________________________
State:______________________________
Zip:____________

Windmill Order:
Size:______________
Price:$_______________

Accessories Order:
Item #1:__________________________
Item #1 Price:_____________________
Item #2:__________________________
Item #2 Price:_____________________

Flagpole Order:
Type:_____________________________________
(Patio/Estate/Continental)
Length:____________________________________
(Example: 15' with 3" butt)
Color: (Satin/Natural)_________________________
Price$_______________________

Flag Order:
Type: (Polyester/Nylon)_______________________________
Size: (3x5, 4x6)_____________________________________
Quanity:______________
Price:$__________________

Total amount of order:$________________________

Use back of order form for comments, etc.
Shipping costs of larger windmills and flagpoles will be provided prior to finalizing order.
Sales Tax required for Iowa residents only.