******************************************************************** (TO PRINT OUT AN ORDER FORM....simply type the letter P ******************************************************************** LONGLASTINGS ORDER FORM **************************** SEND ORDER TO: PO Box 519, Coupeville, WA 98239-0519 ===================================================================== SHIP TO--NAME:___________________________________DATE:_______________ STREET AND/OR PO BOX:________________________________________________ CITY:_________________________________STATE:________ZIP:_____________ ===================================================================== ITEM # | DESCRIPTION OF ITEM | QUANTITY | PRICE/EACH | TOTAL ===================================================================== | | | | _______|___________________________|__________|____________|_________ | | | | _______|___________________________|__________|____________|_________ | | | | _______|___________________________|__________|____________|_________ | | | | _______|___________________________|__________|____________|_________ | | | | _______|___________________________|__________|____________|_________ | | | | _______|___________________________|__________|____________|_________ | | | | _______|___________________________|__________|____________|_________ | | | | _______|___________________________|__________|____________|_________ | | | | _______|___________________________|__________|____________|_________ | | | | _______|___________________________|__________|____________|_________ | | | | _______|___________________________|__________|____________|_________ | | | | _______|___________________________|__________|____________|_________ SHIPPING INFORMATION MERCHANDISE TOTAL |_________ Order Total-------------ADD WA RESIDENTS ADD 6%|_________ Up to $20.00-----------$3.95 SHIPPING (See Chart) |_________ $20.01-$35.00----------$4.95 TOTAL AMOUNT |_________ $35.01-$50.00----------$5.95 $50.01-$75.00----------$7.50 (PLEASE USE ADDITIONAL PAPER IF NEEDED) Over $75.00------------$9.50