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 I
- Item No.
- Description
- Size
- Quantity
- Unit Price
- Item 1 Subtotal
Item 2
- Item No.
- Description
- Size
- Quantity
- Unit Price
- Item 2 Subtotal
Item 3
- Item No.
- Description
- Size
- Quantity
- Unit Price
- Item 3 Subtotal
Item 4
- Item No.
- Description
- Size
- Quantity
- Unit Price
- Item 4 Subtotal

 

Order Total

- Item 1 - 4 Subtotal
- Shipping, Handling and Insurance
- Sales Tax (Utah Residents Only - 6 3/8%)
- Order Total

Within the United States, add:
$ 7.95 for shipping, handling & insurance for orders up to $25.00.
$ 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 for orders up to $100.00. Add $4.00 for each $100.00.

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.