Mac1 ORDER BLANK

13974 Van Ness Ave. Gardena, Ca. 90249

PHONE 310-327-3581 FAX 310-327-0238

Web-site: http://www.mac1airgun.com/

Email: orders@mac1airgun.com

 

NAME ________________________________________C/O________________________________

 

SHIP TO _________________________________________________________________________

 

CITY _________________________________  STATE____  ZIP __________-_______   RES? Y / N

 

 TEL # ________________________________ FAX # ______________________________________

 

E-MAIL _______________________________________________________________ NOTIFY? Y / N

 

NAME ON CARD ________________________________ BILLING? __________________________

                                                                                                       __________________________

 

CARD # ____________________________________________________________ EXP ___________

 

ISSUING BANK ___________________CUST SERV # ______________________________________

 

We accept all major credit cards: AMEX, M/C, VISA & DISCOVER

 

         Item                   Qty         Product Description           Price Each             Total  

1.     1.     __________________________________________________

2.     2.     __________________________________________________

3.     3.     __________________________________________________

4.     4.     __________________________________________________

5.     5.     __________________________________________________

6.     6.     __________________________________________________

7.     7.     __________________________________________________

                                                                    Shipping:  __________________

                                                                                              Subtotal:  __________________

For cards, add 3% of Subtotal:  __________________                                   

                    Residents of California add 8.25% of taxable items:  __________________                                                       

             Add for Adult Signature Request (UPS only) $ 3.00:  __________________

                              Order Total :  ______________