Make your own free website on Tripod.com

Mail In Order Form

To mail in your order, please print out the following order form and send it along with your payment to:
Last
Name:
First
Name:
Middle
Initial:
Address: Cty/St/Zip: Country:
Phone: Fax: Email:

II. Ordering Information
Product
Description:
Qty:
Unit
Price:
Product
Description:
Qty:
Unit
Price:
Product
Description:
Qty:
Unit
Price:

III. Shipping & Handling Information
If your order is:
up to $14.99 add $4.05 from $15.00 to $19.99 add $4.35 from $20.00 to $24.99 add $4.65 from $25.00 to $29.99 add $5.45
from $30.00 to $34.99 add $6.05 from $35.00 to $39.99 add $7.00 from $40.00 to $44.99 add $7.80 from $45.00 to $49.99 add $8.60
over $50.00 add $9.10

IV. Billing Information
Type of Payment (check one):
Money Order: Cashiers Check:

V. Shipping Information
Please specify if shipping address is different than above.
Shipping Address:
Address: Cty/St/Zip: Country:

|BACK|