| |
|
|
| |||||||||
|
ORDER FORM | |||||||||
|
Address: _______________________________________________ | |||||||||
|
City: __________________ State: ____________ Zip:___________ | |||||||||
|
Daytime phone: ( ) _______________ | |||||||||
|
Evening phone: ( ) _______________ | |||||||||
|
SHIP TO (only if different from"ordered by") | |||||||||
|
Name: _________________________________________________ | |||||||||
|
Address: _______________________________________________ | |||||||||
|
City: __________________ State: ____________ Zip: __________ | |||||||||
|
Attention: ______________________________________________ | |||||||||
|
| |||||||||
|
QUANTITY VOLUME PRICE TOTAL | |||||||||
|
_______________________________________________________ | |||||||||
|
_______________________________________________________ | |||||||||
|
_______________________________________________________ | |||||||||
|
Merchandise Total: ________ | |||||||||
|
Shipping and Handling : _______ | |||||||||
|
7.975% Missouri Sales Tax, Missouri residents only: ________ | |||||||||
|
TOTAL: ________ | |||||||||
|
Thank you! | |||||||||
|
| |||||||||
