If you would like to Mail or Fax us an order

If you would like to Mail or Fax us an order, please print this form and complete as necessary. Thank You! Fax to: 402-553-1364

Name: Name on CC if different:
Street Address:
City, State & Zip Code:
Telephone Number:
Credit Card Number: Expiration Date on Card:
Indicate the Quantity of each item and the item number you wish to order here:
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If shipping to a different address than cardholder's address, please include shipping-to information below.	Sub-Total
	S&H (if in NE, incl. 7% sales Tax)
	Total Due

For your information, Here's a quick reference for S&H charges - these are good for orders within the US only.