Name:_______________________________________________________

Address:____________________________________________________

City:_____________________________State:_______Zip:_________

Daytime Phone Number:_______________________________________

Email:______________________________________________________

Shipping Address (If different from above)

Name:_______________________________________________________
Address:____________________________________________________

City:_____________________________State:______Zip:__________

Qty Item #              Description                  Price
--- --------- -------------------------------------  -------
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________

                                       Subtotal_____________
           Wisconsin Residents add 5% Sales Tax_____________
                                       Shipping_____________
                                   Total Amount_____________

Shipping:
  Use the online ordering to determind the shipping charges.

Method of Payment: (Please Circle one)
  Money Order      Check      Master Card      VISA

Credit Card Orders please fill out the information below.(Please Print)

Name on Card ______________________________________________

Credit Card Number ________________________________________

Expired Date ___________________

Your Signature______________________________

 

Orders within the continental United States are shipped via UPS. UPS does not ship to P.O. Boxes. Alaska, Canada and Hawaii customers are charge actual shipping cost. Please e-mail us and we will give you the cost of shipping your order.

 

We accept Master Card or Visa, Check or Money Order. Please allow 2 weeks for orders paid by Check.

Thank You for your order!