Back

84 Payson Road Brooks, ME  04921

Phone (207) 722-3708 Toll Free 1-888-760-7943 Fax (207) 722-3809

Order Info:	Ship To:
Name:	Name:
Address:	Address:
City	City
State Zip State Zip
Daytime Phone Number: Fax Number:

Print, fill out and fax or mail this order form.

Qty	Item #	Item Name/Description	Shipping	Price Each	Total

All Prices are subject to change without notice. Standard shipping will be UPS or US Mail. Please allow 2-3 weeks for delivery.

Subtotal Items:   Shipping Fees:   Add 5% for Sales Tax: (Maine Residents Only)   Total Due:   Total Enclosed:

Select Payment Method:  [ ] Visa    [ ] Mastercard    [ ] Check    [ ] Money Order    [ ] COD	Card Number: Expiration Date:
Signature:
[ ] Ship what is in stock, back order the remainder. [ ] Ship what is in stock, cancel the remainder.

Please fax to: (207) 722-3809 Mail to: 84 Payson Road, Brooks, ME  04921