e-mail:(for delivery confirmation notification)__________________ |
| Name:____________________________________________ |
| Address:__________________________________________ |
| City:_________________________ State____ ZIP
_________ |
| SHIPPING ADDRESS
(if different from above) Name:____________________________________________ |
| Address:__________________________________________ |
| City:_________________________ State____ ZIP
_________ |
| Item No. | Description | Color/Size | Price | Qty. | Total |
| __________ | _______________________ | _______ | $__________ | ____ | $__________ |
| __________ | _______________________ | _______ | $__________ | ____ | $__________ |
| __________ | _______________________ | _______ | $__________ | ____ | $__________ |
| __________ | _______________________ | _______ | $__________ | ____ | $__________ |
| __________ | _______________________ | _______ | $__________ | ____ | $__________ |
| __________ | _______________________ | _______ | $__________ | ____ | $__________ |
| __________ | _______________________ | _______ | $__________ | ____ | $__________ |
| __________ | _______________________ | _______ | $__________ | ____ | $__________ |
| __________ | _______________________ | _______ | $__________ | ____ | $__________ |
| __________ | _______________________ | _______ | $__________ | ____ | $__________ |
| __________ | _______________________ | _______ | $__________ | ____ | $__________ |
| Subtotal |
$__________ | ||||
| CA
residents add 7.75% sales tax |
$__________ | ||||
| Shipping |
$__________ | ||||
| TOTAL |
$__________ | ||||