| ITEM # | ITEM DESCRIPTION | QTY. | PRICE | SUBTOTAL |
| | | | |
| | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | |
ORDER TOTAL _____________
SHIPPING* _______________
TOTAL __________________
NAME ________________________________________________________
SHIPPING ADDRESS _____________________________________________
_____________________________________________________________
PHONE: ________________________
*SHIPPING
| ORDER AMOUNT | USPS STANDARD |
| $0.00 - $30.00 | $5.00 |
| $30.01 - $50.00 | $8.00 |
| $50.01 - $75.00 | $9.00 |
| $75.01 - $100.00 | $11.00 |
| $100.01 - $150.00 | $13.00 |
| $150.01 - $200.00 | $14.00 |
| $200.00 - $250.00 | $15.00 |
| $250.01 and Above | $17.00 |