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PRINT THIS OUT -
PLEASE SEND ALL ORDERS VIA MAIL TO:
719 E. North Street - Poynette, WI 53955
    

                  
NAME:________________________________ E-mail ___________________________
Telephone: ______________________
STREET:__________________________________ CITY:___________________STATE:______ZIP_______ 

Quantity: Product Item#: Color: Size: Price Each: Total:
             
             
             
             
             
             
             
             
             
             
          TOTAL:   
  In WI add 5.5%tax  
ALLOW UPTO 4-6 WEEKS DELIVERY TIME Shipping, handling, and insured delivery  
Prices subject to change without notice

TOTAL with shipping and tax:

 
Shipping - Handling- Insurance  (Note:  Some items need to be sent separately so an additional amount may apply, if you are ordering other items.):
$0-$20.00 $5.95 $50.01 to $65.00 $9.50 $95.01 to $100.00 $13.75
$21.01 to $30.00 $6.20 $65.01 to $75.00 $10.50 $100.01 to $150.00 $15.00
$30.01 to $40.00 $7.40 $75.01 to $85.00 $11.75 $150.01 to $200.00 $20.00
$40.01 to $50.00 $8.50 $85.01 to $95.00 $12.50    
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Enter credit card number:.............................................................

Expiration Date:_________________   Signature:___________________________

graphic Check or Money Order   ($15.00 Service Charge for NFS checks)

Damaged UPS shipments:
inform your local UPS office and advise. 
DO NOT RETURN PKG TO US.