Your Order and Delivery Information


If we are picking up the payment when we deliver, you have to tell us where you are putting the payment, and make sure you give us a phone number to contact you just in case we can't find it:

IF YOU WANT USE PAYPAL AND A CREDIT CARD, YOU ALSO NEED TO GO TO THE SHOPPING CART HERE ONLINE TO PAY.


First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Comments:

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