ORDER FORM
Fax/Mail orders Please Print Out and Send
Credit card orders will be processed within 24 hours of receipt for in stock
merchandise and shipment made accordingly. You will be notified on any item not
In stock and you advise if you wish to wait. No credit card charge will be made
until shipment is made.

Name (Please print)____________________________________ Date___________

Address:_____________________________________________________________

City: ____________________________________State ________Zip:_______-_____

Telephone: __________________________Fax/E-mail:_______________________

Ship to: Name:_______________________________________________________

Address:_____________________________________________________________

City:___________________________________ State ________Zip: _______-_____

Telephone: __________________________Fax/E-mail:_______________________

Visa/MC  No: ____________________________Exp. Date______