PRINT THIS FORM
AND MAIL TO:
Darrell Hover
Phone: (601) 626-0090
Email: darrell@handicone.com
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Order Date _____ / _____ / _____ |
SHIP TO: |
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Address: |
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City, ST, Zip: |
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Please complete this form and enclose Personal Check or Money Order |
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Quantity |
Product Description |
Price each |
Extended Amount |
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18 inch HandiCone
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$24.95 |
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SUBTOTAL |
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SHIPPING & HANDLING |
$9.85
each
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Total Enclosed |
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Please make payments payable to Darrell Hover