If your merchandise subtotal is: Please add: Up to $10.00......................................$6.00 $10.01 to $20.00..................................$7.00 $20.01 to $30.00..................................$8.00 $30.01 to $50.00..................................$10.00 $50.01 to $75.00..................................$12.00 $75.01 to $100.00.................................$14.00 $100.01 to $150.00................................$16.00 Over $150.00......................................$18.00The above listed charges apply for packages which weigh up to 10 pounds. Shipping rates apply to continental United States street address only and are based on packages up to10 pounds. Additional shipping charges may be required for orders outside of the continental United States, and/or orders shipped to PO Boxes or APO/FPO addresses..
Print out this order form on your printer, fill in, and send to:
If your browser doesn't support tables this form will not appear correctly.
| Qty: | Item #: | Description: (Include size and color, if applicable.) | Price Each: | Total Price: |
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| $ | $ | |||
| Subtotal : | $ | |||
| Shipping & Handling : | $ | |||
| Illinois Residents only add 6.6% (sales tax) : | $ | |||
| Total Enclosed : | $ | |||
| Ship to (name): | ||||
| Street address (line 1): | ||||
| Street address (line 2): | ||||
| City, State, Zip: | ||||
| E-mail address: | ||||
| Daytime Phone Number: | ||||
| * * * * * * * For VISA, Discover, or MasterCard orders, fill in the following. * * * * * * * | ||||
| Name as it appears on Credit Card: | ||||
| Account number: | ||||
| Expiration Date: | ||||
| Signature of Card Holder: | ||||