Name: |
Street Address: |
City, State & Zip: |
Telephone Number: |
Email address: |
Payment Type: Check Money Order VISA MasterCard Discover American Express |
Credit Card #: |
Expiration Date: |
Customer Signature: |
QUANTITY | PRODUCT CODE | SIZE/COLOR | DESCRIPTION | TOTAL |
SHIPPING | ||||
SUBTOTAL | ||||
MINNESOTA RESIDENTS ADD 6.875% TAX, MINNESOTA HENNEPIN COUNTY RESIDENTS ADD 7.275% TAX, MINNESOTA ANOKA, DAKOTA, RAMSEY & WASHINGTON COUNTY RESIDENTS ADD 7.125% TAX | ||||
TOTAL DUE |
Order Total | up to $10.00 | $10.01 - $25.00 | $25.01 - $50.00 | $50.01 - $75.00 | $75.01 - $100.00 | $100.01 - $125.00 | $125.01 - $150.00 | $150.01 & Up |
Shipping Charge | $2.25 | $5.25 | $7.25 | $8.25 | $9.25 | $13.50 | $15.50 | $16.50 |