John and Eileen Zanderzuk
1810 Whitlatch Drive
Lancaster, CA 93535
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John and Eileen Zanderzuk 1810 Whitlatch Drive Lancaster, CA 93535
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Name ______________________________________________ Date __________________ Address ___________________________________________ Phone _________________ City ____________________________ State ____________Zip ___________________ E-mail ___________________________________Alternate Phone__________________
Quantity Description Size Price Total
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MINIMUM ORDER $25.00
Subtotal ______________
SHIPPING CHARGES
CA orders - Add 15% CA Res. Add 10.25% tax ______________
Out of State - Add 20% Handling and Packing $4.00
(Any additional shipping costs will Shipping _____________
be forwarded to you with a receipt -
or excess costs will be refunded to you) Total _____________
PLEASE LIST SUBSTITUTES
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