Todays Date Cust. Daytime Phone # Cust. Fax#

Customer Name Address

City State Zip Cust. Email

MC/ VISA/ DISCOVER/AMEX   NUMBER :
EXP DATE

Security code (located in the signature line last three numbers)

Customer Signature ___________________________________________

If Credit card billing address is different than shipping please fill out forms below

Address   City State Zip

Please send my order by (date) -OR- (select option) When Ready Send ASAPCancel order

QTY	ITEM#	ITEM DESCRIPTION (BE SPECIFIC!)	COLOR	SIZE	PRICE

IF ORDER TOTALS... PLEASE ADD $10.00 or less --------------------$6.50 $10.01 TO $25 ------------------  $9.50 $25.01 T0 $50 --------------------$11.00 $50.01 T0 $75 -------------------$12.25 $75.01 T0 $125 -----------------$13.25 $125.01 OR MORE------------$16.75 Any Firearm -------------------$22.00	SUBTOTAL
	<------Shipping, Handling, Insurance
	7% MS Sales Tax
	TOTAL

Large orders quoted separately