ITEM No. ....QUAN............................DESCRIPTION.............................UNIT PRICE.....TOTAL
Items Total:_____________
Ship To: ____________________________________ (please print clearly!)
_______ ______ ______________________________
_________ __________
_______ ______ ______________________________
_________ __________
_______ ______ ______________________________
_________ __________
_______ ______ ______________________________
_________ __________
_______ ______ ______________________________
_________ __________
_______ ______ ______________________________
_________ __________
_______ ______ ______________________________
_________ __________
_______ ______ ______________________________
_________ __________
_______ ______ ______________________________
_________ __________
_______ ______ ______________________________
_________ __________
_______ ______ ______________________________
_________ __________
_______ ______ ______________________________
_________ __________
_______ ______ ______________________________
_________ __________
Shipping ______________ ($0.75 U.S. flat rate all orders - Canada $1.)
Total:_______________
Street Address:____________________________________________________________
City:______________________________________State:____________Zip:___________
e-mail:_____________________________________________________________________