|
Complete Form and Mail
Make Check/Money Order Payable to: Les Brown PO Box 2263 Quincy Mass. 02269 |
| Bill To: | Ship To: | ||||
| Name: | Name: | ||||
| Address: | Address: | ||||
| City: | State: | Zip: | City: | State: | Zip: |
| Phone: | Email: | ||||
| Item # | Color | Size | Qty. | Item Description | Price Each | Total Price |
| 150mmCaliper | x | x |
150mm Plastic Caliper -FREE SHIPPING |
6.99 | ||
| IBM Screw | x | x | 1 IBM Ultrabay Screw -FREE SHIPPING | .99 | ||
| Soft Rim Cap | Red | x | 1 Soft Rim Trackcap -FREE SHIPPING | 5.99 | ||
| 2001 | Red | x | 1 Single Trackcap -FREE SHIPPING | 6.99 | ||
| 2002 | Red | x | 2 Pack of Trackcaps -FREE SHIPPING | 12.99 | ||
| 2004 | Red | x | 4 Pack of Trackcaps -FREE SHIPPING | 19.99 | ||
| 2006 | Red | x | 6 Pack of Trackcaps -FREE SHIPPING | 24.99 | ||
| 2008 | Red | x | 8 Pack of Trackcaps -FREE SHIPPING | 29.99 | ||
| 2010 | Red | x | 10 Pack of Trackcaps-FREE SHIPPING | 34.99 | ||
| 2012 | Red | x | 12 Pack of Trackcaps-FREE SHIPPING | 39.99 | ||
| 2025 | Red | x | 25 Pack of Trackcaps-FREE SHIPPING | 79.99 | ||
| 2050 | Red | x | 50 Pack of Trackcaps-FREE SHIPPING | 149.99 | ||
| 2075 | Red | x | 75 Pack of Trackcaps-FREE SHIPPING | 199.99 | ||
| 2100 | Red | x | 100 Pkg of Trackcaps-FREE SHIPPING | 249.99 | ||
| Free Shipping on all Orders USA: Free Canada: Free * International: Add +1.75 |
Order Subtotal: |
|||||
|
Massachusetts Residents Add 6.0% Sales Tax: |
||||||
|
Add Shipping & Handling if you use chart below: |
||||||
|
Your Order Total Due: |
||||||
|
Use
Shipping and Handling
Chart
below if you prefer us not to ship to you via USPS FirstClass
Mail (Check One) __ USPS Priority Mail __ US Mail Parcel Post __ DHL International |
|||||||
|
Order Subtotal $ 0.00 to $11.99= $12.00 to $24.99= $25.00 to $44.99= $45.00 to $59.99= $60.00 to $99.99= $100.00 to $199.99= $200.00 to $999.99= |
USPS Priority Mail $6.49 $6.99 $8.49 $9.49 $9.99 $10.99 $16.99 |
Low Cost Ground $4.49 $4.99 $6.49 $7.49 $7.49 $8.99 $14.99 |
Int. Order Subtotal $0.00 to $14.99= $15.00 to $49.99= $50.00 to $99.99= $100.00 to $149.99= $150.00 to $199.99= $200.00 to $349.99= $350.00 to $499.99= |
DHL International $12.49 $31.49 $34.49 $41.49 $45.49 $61.49 $68.49 |
|||
| PAYMENT METHODS. PayPal, Check or Money Order. | |
| Signature: | Today's Date: |
©2010 Trackcap.com