SHIPPING information:

Name
Address
Address (cont.)
City
State/Province	Zip
Country
Phone
E-mail

ORDERING INFORMATION:

QTY	CODE	DESCRIPTION	PRICE	TOTAL
		SUB TOTAL:
		*S&H
		TOTAL PRICE:

*Shipping& Handling Charges:
Under $20.00: $6.00
$20-$50: $8.00
Over $50: $10.00

Choose one of the following payment options:

PAY BY:	MO, CHECK #
Money Order
Personal Check