| This online order form is provided to help simplify and organize orders.
It is NOT connected with any CGI script nor does it provide for
e-commerce. You may print it out
as a preprinted form and fill it in by hand or you may type in the details of your
order. When completed, print a copy to use when placing the order. Call (910) 270-3117 to place your order and verify details and costs.
To pay for your order go to the - ORDER PAGE - and follow the instructions at Item No.4 or No.5.
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| Qty | Part # | Description | Unit Price | Total |
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Privacy Statement: We use this information ONLY for processing of your order. We will NEVER provide it to any other company or person.
| Amount of ORDER: Please add up all the "Totals" above. Insert that amount in this cell: | |
| Orders placed within North Carolina MUST add 7.75 % Sales Tax if paying by check or money order only. (If paying by credit card do not add sales tax here. Tax will automatically be added when you enter your credit card information if you live in NC) : | |
| Shipping & Handling Costs USA add $20.00 (excluding Alaska & Hawaii): | |
| ORDER TOTAL: |
Information About Person Placing this Order:
| Name: | |
| Address: | |
| City: | |
| State & ZIP Code: | Phone # |
| E-mail: | For Confirmation & Questions |
Delivery Address (if different)
| Name: | |
| Address: | |
| City: | |
| State & ZIP Code: | Phone # |
Once you've QUIT your program or CLOSED this window, ALL the information
you've typed will disappear. Make sure that you print two copies first.