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PLEASE PRINT ---- SHIPPING ADDRESS:_E-Mail Address: _____________@_____________________
NAME:_______________________________________________
ADDRESS:____________________________________________
CITY:_______________________STATE:___________________ZIP:__________________
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| ITEM NUMBER |
DESCRIPTION |
QUANTITY |
PRICE@ |
| ___________ |
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| ___________ |
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| ___________ |
_______________________________________ |
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_______________________________________ |
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| ___________ |
_______________________________________ |
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_______________________________________ |
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_______________________________________ |
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| SUB-TOTAL___________ |
| Special: take 5% off of your order here ___________ |
| New Jersey Residents Only, please add 7% sales tax on all orders ___________ |
| SHIPPING & HANDLING ( All orders see below ) ___________ |
| All QUARTER MAP & LARGE OAK FRAME ORDERS: (Weight & Oversized) Add EXTRA $2.00___________ |
| OUT of U.S.A. Add EXTRA (Canada $20.00) Over Seas ($50.00) un-used postage will be returned___________ |
| ( _ ) Pay-Pal - - ( _ ) Cash - - ( _ ) Check - - ( _ ) Money Order--( _ ) Credit Card |
| ( _ ) Visa ( _ ) Master Card ( _ ) Amer. Express - Credit Card # _______-_______-_______-_______, |
| exp date: _____/_____, security code: _____, Signature:____________________________________ |
| U.S. FUNDS ONLY: Thank You |
| TOTAL INCLOSED_______________ |
- SHIPPING & HANDLING
- 0 to $3.99 add $2.75
- $4.00 to $9.99 add $4.50
- $10.00 to $16.99 add $6.50
- $17.00 to $24.99 add $8.50
- $25.00 to $34.99 add $9.50
- $35.00 to $49.99 add $10.50
- $50.00 and up add $12.50
- MAP & LARGE OAK FRAME ORDERS: Add EXTRA $2.00
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- Checks/MO payable to: Disk Works of South Jersey
- MAIL TO: Disk Works of South Jersey
- 187 Clayton-Aura Road
- Glassboro, New Jersey 08028-3404
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