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| _________SHIP TO:_____(PRINT CLEARLY!) | ____BILL TO:____(PRINT CLEARLY!)_ |
|---|---|
| NAME:. | NAME:. |
| ADDRESS:. | ADDRESS:. |
| CITY:. | CITY. |
| STATE:________________ZIP: | STATE:________________ZIP: |
| PHONE: (_____) | PHONE: (_____) |
| Quantity | Item | Price | Sub Total | |
|---|---|---|---|---|
| ______ | . | $ | $________ | |
| ______ | . | $ | $________ | |
| ______ | . | $ | $________ | |
| ______ | . | $ | $________ | |
| ______ | . | $ | $________ | |
| ______ | . | $ | $________ | |
| ______ | . | $ | $________ | |
| ______ | . | $ | $________ | |
| ______ | . | $ | $________ | |
| ______ | . | $ | $________ | |
| ______ | . | $ | $________ | |
| ______ | . | $ | $________ | |
| * | * | Sales Tax 8.25% if in Texas | $________ | |
| * | * | Shipping & Handling | $________ | |
| * | Sales to USA and CANADA only | Total | $________ |