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         Main Page          Middleburg           Email
117 W. Washington Street (next to the Post Office)
540-687-6590   ~   800-371-9924

 

 

 

 

 

 

Email Order Form

ORDERED BY:
NAME:
ADDRESS:
ADDRESS:
CITY:
STATE:
ZIP:
VOICE:
FAX:
E-MAIL:


 

SHIP TO:

NAME:
ADDRESS:
ADDRESS:
CITY:
STATE:
ZIP:
VOICE:


DESCRIPTION

 Color
  Size QTY. PRICE
$
$
$
$
$

Product Total

 $

VA residents add 4.5% Sales Tax

 4.5% $

 Shipping (see table)

Grand Total

 $

SHIPPING and HANDLING

 Total each Address

 USA

 Canada

 Europe

 All Other
ppup to $15.00
$15.01 - $30.00
$30.01 - $40.00
$40.01 - $50.00
$50.01 - $75.00
$75.01 p- $100.00
$100.01 - $200.00
ppppOver $200.00		 $4.45
$5.95
$6.95
$7.95
$8.95
$9.95
$10.95
$12.95		 $8.00
$9.00
$10.00
$11.00
$12.50
$15.00
$20.00
$25.00		  $10.00
$11.00
$12.50
$15.00
$18.50
$20.00
$25.00
$35.00		 $20.00
$22.00
$24.00
$26.00
$28.00
$30.00
$35.00
$50.00
Alaska, hawaii and U.S. Territories: Please add $5.00 to the USA shipping and handling charge


For Phone Orders
Please Call during Business Hours
Monday-Saturday 9 a.m.-5 p.m.

540-687-6590 ~ 800-371-9924

PAYMENT METHOD:

CARDMEMBER NAME:

CARDMEMBER ADDRESS:

CREDIT CARD NUMBER:

EXPIRATION DATE:

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