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Request Print Catalog
To order from our catalog, please print out the form below,
then fill it out and mail or fax it to us.
FAX: 510-527-7718
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Qty.
Description
Price Each
Total
Amount
CA Delivery Add Sales Tax
Packaging and Insurance
2
00
Shipping Charge 15% of Amount ($6.00 Minimum)
Total Enclosed with Order
Payment Method:
Check/Money Order
or
Credit Card:
Visa /
Mastercard /
Discover
Card Number: ______ - ______ - ______ - ______ Expiration Date ___ /_______
Signature_________________________________ Date___________
E-mail and Phone Number:
(so we can contact you if there are any questions regarding your order)
E-mail address: _________________________________________
Phone:
(home)
_________________
(work)
__________________
Mailing Address:
Name:___________________________________________________________________
Address:_________________________________________________________________
City: _______________________________ Zip: ______________
Shipping Address:
(if different from above)
Name:___________________________________________________________________
Address:_________________________________________________________________
City: _______________________________ Zip: ______________
