Name:

First Name
Last Name
Middle Initial
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Order Information:

QTY	DESCRIPTION	TOTAL COST
	Lapel Pins
	Gift Items
	Ties
	Auto Accessories
	Books/Tapes/CDs
	Display Items
	Decals/Stickers
	Product Total......................................................
	*Add US Shipping & Handling (from chart below)
	Florida Residents add 7% sales tax on product total
	Grand Total  (amount to be charged to credit card)..........

*Shipping & Handling Chart:

Order Amount	Add
Less than $5.00	$1.00
$5.00 - $30.00	$3.50
$30.01 - $50.00	$5.00
$50.01 - $80.00	$8.50
$80.01 - up	No Charge
Rush Holiday Order (US Post Office Priority Mail)	$15.00

 

PAYMENT Information:

Money Orders Preferred
Make Payable to:
Michael Herring

Mail Order to:
Michael Herring
916 Lakemont Hills Blvd.
Brandon, FL 33510 - 2540

ALTERNATE SHIPPING INFORMATION:

	SHIPPING - IF DIFFERENT FROM ABOVE
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

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