| Order Form | |||||
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Bill To: |
Ship To: |
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| DATE: | PO#: | ||||
| QTY | Item # | Description | Price | Extended Price | |
| Total of items: | |||||
| Shipping: | |||||
| Grand Total: | |||||
| Dollar value | Shipping rate: | ||||
| $0.01 - $19.99 | $4.95 | ||||
| $20.00 - $49.99 | $7.95 | ||||
| $50.00 - $99.99 | $8.95 | ||||
| $100.00 - $199.99 | $15.50 | ||||
| $200.00 and over | $18.95 | ||||
| Please include order amount and shipping charge. | |||||
Before mailing your order, please email us for payment instructions. |
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Order can be mailed to: |
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