|
|
|
|
total amount |
| ________ | _______________________________________ | ____________ | __________ |
| ________ | _______________________________________ | ____________ | __________ |
| ________ | _______________________________________ | ____________ | __________ |
| ________ | _______________________________________ | ____________ | __________ |
| ________ | _______________________________________ | ____________ | __________ |
| ________ | _______________________________________ | ____________ | __________ |
| ________ | _______________________________________ | ____________ | __________ |
| ________ | _______________________________________ | ____________ | __________ |
| subtotal from above | _________ | ||
|
shipping and handling (see below) |
_________ | ||
|
OK sales tax (8%) if Oklahoma resident |
_________ | ||
| Canadian or Foreign Orders | _________ | ||
| total- | _________ | ||
| circle either: VISA or MASTER CARD |
| credit card #: |
| expiration date: |
|
name on credit card and billing address:
|
|
signature: |