Mail In/Fax Order Form
| Item Name | Description | Size | Unit Price | QTY | Price | |
| Shipping Method
Price Standard Delivery $5.95 USD 4-5 Business Days (FREE if order is over $50.) Priority Delivery $7.95 USD 2-3 Business Days Express Delivery $24.95 USD 1-2 Business Days |
Order Subtotal | |||||
| Shipping & Handling | ||||||
| Sales Tax
MD Deliveries Require 5% Sales Tax |
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| TOTAL DUE | ||||||
| Payment Method:
□ Visa □ MasterCard □ American Express □ Discover □ Money Order Card No.: _____________________________________________________ Expiration Date (Month/Year):_____________________________________ CVV² Code: ______________________________ (last 3 Digits on the back of your card/ AMEX front 4 digits top right side of card) Name On Card: _______________________________________________ Signature:____________________________________________________ |
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| Billing Address | Shipping Address (If Different From Billing) |
| Name: | Name: |
| Address: | Address: |
| City: | City: |
| State: | State: |
| Zip Code: | Zip Code: |
| Email: | Email: |
| Daytime Phone #: | Daytime Phone #: |