| ORDERED BY: | SHIP TO: (ONLY if different from "Ordered By".) |
|---|---|
| Name: | Name: |
| Street: | Street: |
| City: | City: |
| State & Zip: | State & Zip: |
| Email Address,If any questions about your order: |
| Quanity | Description | Cost | TOTAL |
|---|---|---|---|
Shipping Charges $1.00 to $20.00 =$6.00 $20.01 to $35.00=$8.00 $35.01 to $50.00=$12.00 $50.01 to $70.00=$15.00 $70.01 & above=$20 International Orders please add $5.00 Handling Fee. If you would like insurance, please add $1.80 for sub-totals up to $50, $2.20 for up to $100. | SubTotal from above |
| CA sales tax 8.00% (if applicable) | |
| Shipping | |
| TOTAL ENCLOSED $ |