Order Form

Print this form to order by mail or call 540-869-2148

CREDIT CARD INFORMATION

Name on Card -

Card Number -

Exp.date Circle One: VISA M/C

CUSTOMER INFORMATION

Customer Name

Address

City State Zip Code

Home Phone #

Work Phone # Email Address

Shipping & Handling

$40 to $59.99 -------- $6.95

$60 to $79.99 -------- $7.95

$80 to $99.99 -------- $8.95

$100 and up ---------$10.95

Outside USA add $10.00

5.0% sales tax for Virginia residents

If you are not completely satisfied,
we will provide a refund or exchange within 30 days.
Shipping charges are non-refundable