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MAIL ORDER FORM |
5725
Highway 111 North |
|
MAIL ORDER FORM |
5725
Highway 111 North |
Print this page out and include payment with mailing.
SHIPPING ADDRESS: Name: __________________________________ Residence?: _____
Street Address: ______________________________________________________________
City: ____________________________ State/Province:_________ Zip Code: ____________
Telephone: (____)_____________________ E-mail: _________________________________
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Description
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Size/Color
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Qty.
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Price Ea.
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Total
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| Subtotal: | ||||
| Tennessee residents add 9.75% sales tax: | ||||
| Shipping/Handling: | ||||
| Total Due: | ||||
Payment Type: Personal Check : _____ Money Order/Cashier's Check: _____
Credit Card Type (Visa or MC):________ Number:______-______-______-______
Expiration Date (MM/YY):_____/_____
Billing Address (if different from above):_________________________________
___________________________________________________________________
NO C.O.D.'s