Order Form

  

Checks, Money Order, or Credit Card only. All payments must be made in US dollars.
Personal check must be drawn upon a US bank. Please allow 5 days for clearance of personal checks.

  

Item Name

Quantity

Price

Total
       
       
       
       
 
:

Sub total

 

Pennsylvanian residents please Add 6% Pa. Sales tax

  
Please add one the following shipping cost to order
US: $6.00 CANADA: $8.50 INTERNATIONAL AIR: $18.00

Add Shipping

 

GRAND TOTAL
(in US dollars only)

  

SHIPPING INFORMATION
NAME:  
ADDRESS 1  
ADDRESS 2  
CITY  
STATE/PROVINCE   ZIP:                    COUNTRY
PHONE NUMBER  
E-MAIL ADDRESS  
IF PAYING BY CREDIT CARD PLEASE FILL OUT INFORMATION BELOW

NAME ON CARD

  

VISA OR MASTERCARD

 VS EXP DATE (mm/yy): CVC#:
MC CREDIT CARD #

PLEASE MAIL ORDER TO:
LINDA HELLER
PO BOX 243
REAMSTOWN, PA. 17567 USA

Checks, Money Order, or Credit Card only. All payments must be made in US dollars.
Personal check must be drawn upon a US bank. Please allow 5 days for clearance of personal checks.