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Sub Total |
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Shipping |
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For C.O.D. add $5.00 |
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Total |
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Date of Order |
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Date of Order |
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Name |
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Name |
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Address |
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Address |
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City - State - Zip Code |
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City - State - Zip Code |
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Daytime Phone |
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Daytime Phone |
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Visa / MC Number - Expiration Date |
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Signature - Date |
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METHOD OF PAYMENT
1. Certified Check, Personal Check, Money Order, Visa or Master Card.
2. Attention Credit Card Users: Visa or MC number, expiration date, and signature must be filled out. Send this form to below address or fax to (509) 299-5525.
3. For C.O.D. add $5.00
4. Important: Be sure to fill out the Item Number, Description, and Quantities for the products you want to purchase.For questions on ordering e-mail: lizberry2855@aol.com