| Item Description | Qty | Price | Total |
| 1. | ____ | $ | $ |
| 2. | ____ | $ | $ |
| 3. | ____ | $ | $ |
| 4. | ____ | $ | $ |
| 5. | ____ | $ | $ |
| 6. | ____ | $ | $ |
| 7. | ____ | $ | $ |
| 8. | ____ | $ | $ |
| 9. | ____ | $ | $ |
| 10. | ____ | $ | $ |
| 11. | ____ | $ | $ |
| 12. | ____ | $ | $ |
| Subtotal |
$ |
||
| Shipping and Handling | $ | ||
| .......$ 25- 49.00 ..........$ 7.50 | |||
| .......$ 50- 99.00.......... $14.00 | |||
| .......$100-150.00.........$18.00 | |||
| Sales Tax for Texas Only 8% | $ | ||
| Grand Total | $ |
| Credit Card Charge M/C __ or VISA ___ | Ship To: |
| Name on card________________________ | ____________________________________ |
| Signature ___________________________ | ____________________________________ |
| Expires ___________ | ____________________________________ |
| ____________________________________ | |
| City___________________ ST___ Zip_____ |