mouse pad order form

First Name______________________________

Last Name __________________________________

Address _________________________________________

City ________________________________ State ____ Zip ____________

Day time phone ___________________________

PAYMENT BY: Check or money order (sorry no C.O.D.s)  

VISA M/C AMERICAN EXPRESS DISCOVER CARD  

Account Number ______________________________________  

Cardholder's Signature __________________________________ Date ______  

Qty Total
_____
X $19.95
 _____
WA residents add $1.72 sales tax per each item _____
Shipping and Handling$4.95 for first item
 _____
Add $.50 for each additional item
_____
Add $7.00 for FedEx overnight delivery
 _____
Add $6.95 for international shipments
 _____
Order total
 _____

Blue, one size fits all  

Return this form to:
OZ Enterprises
1013 Stone Brook Dr SW
North Bend WA, 98045

OR fax (801) 469-3163