Name:______________________________________________________Date:____________________
Phone__(____)_________________Best hours to call____________email________________________
Name:______________________________________________________________________________
Phone__(____)_________________Best hours to call____________email________________________
We are moving toward communications in email. If you would like notification of new products and sales please let us know your address. We are hoping for a news note every quarter. We do not sell email addresses.
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Method of Payment |
Issuing Bank______________________________ |
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_______Payment Enclosed ( Do not Send Cash) |
Expiration Date____________________________ |
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____VISA _____Master Card |
Signature________________________________ |
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____Discover _____American Express |
3 digit number of the back of the credit card____________ |
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Account Number ________________________________ |
If American Express: 4 digit number on the front of the card/ not part of the account number____________________ |
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Handling and Shipping Fee |
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$3.00 |
Subtotal___________
Sales Tax for Nevada Residents___________
Total ___________
A Shipping charge will be added to your order at our cost to ship
Circle one: UPS Ground, UPS 3 Day, UPS 2 day, UPS Next Day, USPS Priority Mail, USPS 1st class, (13 oz or more it becomes Priority mail,) Parcel Post
Include insurance ?_____________________
Is this a residence?______________________
Is your location rural?___________________