Bill to:				   	   Ship to (if different):

Name:	___________________________   Name:   ___________________________

Address:___________________________   Address:___________________________

        ___________________________           ___________________________

City:   ___________________________   City:   ___________________________

State/Province:____________________   State/Province:____________________

Zip/Postal Code ___________________   Zip/Postal Code____________________


Telephone Number:__________________
		 
Payment by:
_____Check    _____Visa     _____MasterCard    _____Discover Card _____American Express
Card Number:______________________
Expiration Date:____________        Signature:_____________________________  
__________________________________________________________________________________
|Item Number |          Product             | Quantity   |   Price    |  Total   | 
|____________|______________________________|____________|____________|__________|
|            |                              |            |            |          |
|____________|______________________________|____________|____________|__________|
|            |                              |            |            |          |
|____________|______________________________|____________|____________|__________|
|            |                              |            |            |          |
|____________|______________________________|____________|____________|__________|
|            |                              |            |            |          |
|____________|______________________________|____________|____________|__________|
|            |                              |            |            |          |
|____________|______________________________|____________|____________|__________|
|            |                              |            |            |          |
|____________|______________________________|____________|____________|__________|
							              
             			                	     Subtotal __________
                                                                      
                                                Shipping and Handling __________
  								            
				Sales Tax (California Residents Only) __________
                                                                               
                                                		Total __________         
Shipping/Handling to Destinations in the United States:
 - U.S. Orders under $35.00  - Please add $3.50
 - U.S. Orders over $35.00 - Please add 10 percent of the subtotal.
The shipping/handling charge for orders sent to Canada is 6.00 if the subtotal is
under $35.00 and 15 percent if the subtotal is over $35.00. Shipment to other countries
will require additional charges.       
If you wish to return an item that was shipped to you, please contact us within 45 days for a return authorization number.