Name
 

Street Address
 

City                                                                                            State                                    Zip
 

Phone                                                                                          

e-Mail
 

Quantity

Name and Description of Item

Color / Size
(if applicable)

Price Each

Total Price

SubTotal $

California residents must add 8.25% Sales Tax

Tax

SubTotal  $         Shipping
$0.01   -  $10.00      $4.95         $10.01 -   $25.00      $6.50        $25.01 - $35.00        $7.95
$35.01  - $50.00      $8.95         $50.01 -   $65.00    $10.50        $65.01 - $100.00     $11.95
                                            $100.01 -   UP           FREE
        ***  FREE SHIPPING is only applicable to the Continental United States  ***
                                All others must e-mail us for the prevailing rate.

Shipping

 * When Mailing your Order,
remember also, to include your Payment.

Order

Total $

Thank you for your Order