Email Address:  
Name:  
Phone:   --
Billing Address:  
Ship To Address:  
Rep-ID:  
Products Info  
Item Qty. Unit Price Qty. times Price
Subtotal
Shipping/Handling
Sales Tax (LA Residents Only)
Order Total

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Payment Method

Card Type:
Card No:
Expiration Date (mm/yy):
Name Appearing on Card:

Mail Checks or Money Orders to Address


Shipping & Handling
Shipping Services Add For Shipping
$1.00 - $25.00 $5.00
$25.01 - $50.00 $10.00
$50.01 - $75.00 $15.00
$75.01 - $100.00 $20.00
$100.01 or More FREE


Special Delivery Services
Shipping Services Add For Shipping
Minimum Freight $5.00
Freight Add 15% for UPS Ground Service
1 - 2 Days Rush Service Add 35% for S & H
Parcel Post Add 20% for S & H
Rush Service Saturday Service Add 35% + $10 for S & H
Airmail (Parcel Post) Add 30% for S & H

Email

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