Product Request Form: |
CHECKS PAYABLE TO: |
A J'S OUTDOORS, INC. |
MAIL TO: |
BOX 76167
TAMPA, FL 33675
(813) 259-9884 |
ORDER BY FAX
(813) 258-0303 |
|
Payment By: CHECK _____ M.O. _____ VISA _____ MC _____ |
# |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
EXPIRATION DATE REQUIRED |
|
|
|
|
|
Cardholder's Name: _____________________________________________ |
Cardholder's Signature: ___________________________________________ |
|
SOLD TO: |
Name: _______________________________________________________ |
Address: _____________________________________________________ |
City: __________________________ State: ____ Zip: _________________ |
|
SHIP TO: |
Name: _______________________________________________________ |
Address: _____________________________________________________ |
City: __________________________ State: ____ Zip: _________________ |
PRICING: |
FS-18-1 1 @ $11.95 / 2 @ $10-95 Each / 3 @ $9.50 Each |
FS-24-1 1 @ $12.95 / 2 @ $11-95 Each / 3 @ $10.50 Each |
|
SHIPPING & HANDLING: |
1 Unit - $3.95 |
2 Units - $4.95 |
3 Units - $5.95 |
|
|