Date:_____________________ Delivery Date requested:__________________________
Name:________________________________________ email:_________________________
Address:_____________________________________ City:_____________________________
State/Province:__________________ ZIP Code:_____________ Country:_______________
Send: flyers ____, catalogs ____, or email ____ on new products or updates?
________________________________________________________________________________
Product/ | Order Info., such as: | | Each | Total
Part | Color, size, border, etc. |Quan-|Price|Ship-|Price|Ship-
Number | Description |tity | |ping | | ping
| | | | | |
___________|______________________________________|_____|_____|_____|_____|_____
| | | | | |
___________|______________________________________|_____|_____|_____|_____|_____
| | | | | |
___________|______________________________________|_____|_____|_____|_____|_____
| | | | | |
___________|______________________________________|_____|_____|_____|_____|_____
| | | | | |
___________|______________________________________|_____|_____|_____|_____|_____
| | | | | |
___________|______________________________________|_____|_____|_____|_____|_____
| | | | | |
___________|______________________________________|_____|_____|_____|_____|_____
| | | | | |
___________|______________________________________|_____|_____|_____|_____|_____
| | | | | |
___________|______________________________________|_____|_____|_____|_____|_____
| | | | | |
___________|______________________________________|_____|_____|_____|_____|_____
| | | | | |
___________|______________________________________|_____|_____|_____|_____|_____
| | | | | |
___________|______________________________________|_____|_____|_____|_____|_____
Subtotal| | V
________________________________________________________________|_________| V
5.5% or 5.6% WI Sales Tax if applicable | | V
(Please enter applicable WI County: | | V
|
Put shipping subtotal here |
|
Enter $2.50 handling/order ($5 COD) unless otherwise spec'd |
|
TOTAL |