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Name:_____________________________________

Address:___________________________________

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City:________________ ST_______ ZIP________

Telephone: (_____)_________ - _____________


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Exp. Date________
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SUB TOTAL:

US POSTAL SERVICE:
$3.00 for 1 item, $4.00 for 2 items, $5.00 for 3 items.
Priority Mail used for all orders of 4 items or more: $6.00

UNITED PARCEL SERVICE (UPS): $6.50 per order

NEW YORK RESIDENTS ADD 8.25% Sales tax

TOTAL