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Line #

Item Description

Color

Size

Cat. # (opt.)

Quantity

Price
each

Total

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Merchandise Total

$

   

Shipping & Handling (Refer to chart Below)

$
   

Please add 6% sales tax

$
   

Total

$

                         MERCHANDISE FREIGHT COST                        
$Amount Per Order                   Cost:
         0-29.95$                            4.95$
     30.00-49.95$                        6.95$
     50.00-74.95$                        8.95$
     80.00-99.95$                      10.95$
   100.00-149.95$                    12.95$
   150.00-400.00$                    17.95$
Over 400.00$ 5% of Merchandise Total

Payment Method

        C.O.D.

      Check (enclosed) Check #                                     

      Visa/Mastercard     Card Number#                                              exp. date             

Bill to/Ship to: Name                                                                   

Address                                                                                         

City, Street, Zip                                                            Phone #                                     

 

If you have any questions, Please Contact Us

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