Order Form for Customers Paying with PayPal 


Please provide the following ordering information:

Note:  DO NOT USE THE ENTER KEY (it will transmit this form prematurely).
Use Tab key or mouse to move from one space to another.

E-mail address (Very Important)

 

QTY ITEM # DESCRIPTION PRICE

(Additional items can be entered in the comments box at the bottom of this form)

 

  Sales tax 8% of above total 

Only for shipments to California
 

ALL SHIPPING IS FULLY INSURED

Total special shipping charges
(if any) from item's description

Shipping charge from chart below

Leave this box blank- you do not pay this- if you have entered a special shipping charge above.   

SHIPPING CHARGE CHART

TOTAL MERCHANDISE AMOUNT  
Orders $99.99 and under $8.95
$100 - $200 $9.95
$200+   $10.95
Foreign orders $19.95 minimum

 

CUSTOMER INFORMATION
Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
Home Phone

SHIPPING ADDRESS - ONLY IF DIFFERENT FROM ABOVE
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
COMMENTS
(Is this a lay-away?  Do you qualify for a free offer?  Special Instructions?)
You may wish to print a copy of this form now for your records.  
Please click the button below to submit your order,
then click the PayPal link on the next page