LAND/Shark - StealthBag FAX-BACK ORDER FORM
 Print out this page. Complete the form below, and fax it to 818-997-0425. The items with * are required in order to process your order properly. Note: Please include your Name EXACTLY as it appears on your Credit Card, and provide your Credit Card BILLING ADDRESS in the fields below. If you require a different "Ship To" address, include that information in the "Comments or Questions" section below.

* Name:
 
* Address:
 
Address:
 
* City, State, Zip:
 
* Country:
 
* Telephone Number:
 
Fax Number:
 
* E-Mail Address:
 
* Payment Method:
 ____ Visa   ____ MC   ____ AMEX
* Credit Card Number:
 
* Expiration Date:
 (MM - YY)   _______  /  _______

Quantity
Product
Unit Cost
Extension
#
LAND/Shark
$69.95†
$
#
StealthBag
$69.95
$
  • California Residents add 9.75% Sales Tax.
  • All Domestic Orders will be shipped UPS Ground (where available) or US Mail and insured.
  • $6.99 shipping on a single unit.
  • Add $4.00 shipping for each additional unit ordered at the same time and being shipped to the same address.
  • Foreign Orders shipped Federal Express Only (actual shipping charges will be sent to you by e-mail).
†This is a Limited Time Offer. Prices subject to change without notice.
Sub Total:
$
Sales Tax:
$
Shipping:
$
Foreign Shipping:
TBD
Total:
$

Comments or Questions:
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___________________________________________________________
___________________________________________________________
___________________________________________________________
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