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Mail this form along with your check or money order payment to:
Credit Card Orders can be Phoned:
Cell:(814)-664-0402 Ph:(814)-664-7549
| Ship to: |
| Name: Address: City: State: Zip Code: |
| Payment Info: |
| Credit Card Type: Credit Card Number: Expiration Date Month: Year: Name of Cardholder: Phone Number: (note: necessary for processing credit card) |
| Order Info: | |||
Item Quantity |
Description |
Price Each |
Total Price: |
Shipping |
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Total |
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Ordering More Than One Item?
Shipping & Handling Chart
Total Dollar Amount of Order - Shipping Charge$ 0.00 - $28.00 ------------- $ 8.95
$ 28.01 - $50.00 ----------- $ 10.95
$ 50.01 - $75.00 ----------- $ 13.95
$ 75.01 - $100.00 ----------$ 16.95
$ 100.01 - $200.00 --------$ 18.95
