ORDER FORM

Name:

Address:

City:

State:

 		Zip Code: Apt #:

E-Mail:

Promo Code:

Item(s):

Shipping:

***PAYMENT MUST BE MADE VIA PAYPAL OR MONEY ORDER: Once your order is placed, you will receive an email detailing how to pay. For orders of more than three items, please email us for special "bulk rate" shipping costs. A completely and properly filled out form is needed to process your order. You will not receive an order confirmation/payment instruction email if you do not properly and fully fill out the above form.