Address: ________________________________________________________________
City:____________________________________________________________________
State / Province:__________________________Zip / Postal Code:__________________
Country:_________________________________________________________________
Telephone #:__________________Fax #:_________________Email:_________________
Visa _ MasterCard_ Number:__________________________________________________
Expiration Date:___________________________________________________________
QUANTITY ITEM DESCRIPTION COLOR/NUMBER UNIT PRICE TOTAL PRICE ________ ______________________ ____________ __________ ___________
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SHIPPING COSTS: Subtotal: __________
Out of State: UNDER $50.00....$ 7.25 *Sales Tax: __________ OVER $50.00....$ 9.25
California: UNDER $50.00....$ 5.50 Shipping: __________ OVER $50.00....$ 8.25
Canada: UNDER $50.00....$15.00 TOTAL: __________ OVER $50.00....$20.00
**EXTRA HEAVY ORDERS WILL BE PRORATED VIDEO SHIPPING COSTS: *California Residents Only Single: $5.50 Add 8.25% Sales Tax (as of January 1, 2002) Two : $7.25 Three : $8.25 **Visa, MasterCard,U.S. Postal Money Orders, Checks or Equivalent U.S. Dollars ONLY ***All Shipments US Priority Mail Insured***