Name: Address: Address: City: State: Zip: Phone: Fax: Email: Credit Card Type: Discover, Visa or Mastercard Credit Card #: Expiration Date: 3 Digit Validation number on back of card:
Shipping Information (if different than billing):
Name: Address: Address: City: State: Zip: Phone: Fax: Email:
All orders will have a minimum charge of at least $5.00 added for shipping, if weight exceeds the minimum, additional charges will be applied. We will ship by Priority Mail if possible. UPS Ground, Second Day and Next Day Air are available.
Orders shipped to Florida will also include appropriate sales tax.
Comments or additional instructions.