Billing Information (must match exactly with information credit card company has on file):

*Required

- Name*
- Street Address*
- City*
- State/Province*
- Zip/Postal Code*
- Country*
- Day Phone No.*
- Night Phone No.*
- E-Mail Address*

Shipping Information (if different from billing address - US only):

- Name
- Street Address
- City
- State/Province
- Zip/Postal Code
- Country
- Day Phone No.

Method of Payment:

Visa MasterCard American Express Discover

- Name on Card
- Account No.
- Expiration
- CVV2 Code
- Bank Issuing Card

Items Ordered:

Item 1
- Item No.
- Description
- Quantity
- Unit Price

Item 2
- Item No.
- Description
- Quantity
- Unit Price

Item 3
- Item No.
- Description
- Quantity
- Unit Price

Item 4
- Item No.
- Description
- Quantity
- Unit Price

Order Total
- Subtotal
- Shipping and Handling (please see chart below):
- Sales Tax (Utah residents only -- 6.85%)
- Order Total

Within the United States, add:
$8.95 for shipping, handling & insurance for orders up to $50.00.
$10.95 for shipping, handling & insurance for orders $51.00 to $100.00.
Add $ 2.00 for each additional $100. (USPS Priority Air Insured)
$24.00 - Express up to $100.00. Add $4.00 for each additional $100.00.

International, add:
Express Mail Insured - $36.00 up to $100.00 for shipping, handling and insurance.
Add $4.00 for each additional $100.00. (allow 10 to 20 business days for delivery, depending on customs)
May not be able to ship to some countries.

Please be sure an E-Mail Address and Phone Number is included on your order.
We use the United States Postal Service for all shipping.