|
Name:
_______________________________________________________ |
| Yacht Club:
___________________________________________________ |
| Address:
_____________________________________________________ |
| City: ________________________ |
State/Prov: ___________________
|
| Country: _____________________ |
Postal Code: __________________
|
|
Phone: (____)
______________
Fax ( ____) _______________
|
|
E-mail Address
_______________________@________________ |
Use image attached ____
or Use Burgees.com image ____ |
|
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|
Quantity |
Size |
Price |
Total |
|
|
Qty ___ |
Size _____ x _____ |
$_________ |
$ ________ |
|
|
Qty ___ |
Size _____ x _____ |
$_________ |
$ ________ |
|
|
Qty ___ |
Size _____ x _____ |
$_________ |
$ ________ |
|
|
Sub Total |
$ ________ |
|
|
Artwork/Tooling Charge: |
$35.00 |
|
| |
Handling Fee: |
$ 15.00 |
|
| |
California Sales Tax 8% (CA
Residents only): |
$ _________ |
|
|
Shipping: |
$12.00 |
US
Only * |
|
|
|
Total: |
$ ________ |
|
| |
| Send Check or
Money Order Payable to: |
| Halling Enterprises |
|
2622 Kempton Drive |
|
|
Los Alamitos CA 90720 USA |
|
| |
|
| |