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

Within the United States, add:
$10.95 for shipping, handling & insurance for orders to $100.00.
Add $ 5.00 for each additional $100. (USPS Priority Air Insured)
$34.00 - Express for orders up to $200.00. Add $6.00 for each $100.00.

International, add:
Express Mail Insured - $44.00 for orders up to $100.00 for shipping, handling and insurance.
Add $8.00 for each additional $100.00. (allow 10 to 20 business days for delivery, depending on your 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.