Company Name
Company Address
Company Phone Number
Company e-mail address

ORDER FORM

Print & Fax or Mail this form to order our products. Please allow 10 days for delivery, from date of receipt.
[#1] Enter your choice items here.

Item#________ Quantity____ Cost@_______ Cost x Quantity _________
Item#________ Quantity____ Cost@_______ Cost x Quantity _________

Total Merchandise: $___________________
[#2] Determine shipping and handling charges using this chart 

 # Items   WA, OR, ID    W. of Rockies    Other U.S.A.
____________________________________________________________
 1-2    $ 5.50           $ 6.00          $ 8.00
 3-5      6.50             7.00           12.00
 6-10     7.00             8.50           16.00
11-15     7.50             9.50           20.00
16-20     8.00            12.50           30.00

Shipping & Handling Charges: $___________________
[#3] Total your purchase

TOTAL DUE: $________________

[#4] Fill out payment coupon

Name ____________________________________________________
Address _________________________________________________
City ______________________ State ______ Zip ____________
Telephone _______________________________________________
BankCard No. ______________________ Expires ___/___/_____
__ MasterCard __ Visa __ American Express
Make checks payable to Company Name.

All sales carry this guarantee
IF YOU ARE NOT COMPLETELY SATISFIED WITH YOUR PURCHASE, RETURN IT TO WITHIN TEN DAYS OF RECEIPT, WE WILL REFUND YOUR MONEY WITH NO QUESTIONS ASKED.

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