Order Form Sold To: Name:________________________________________ Address:______________________________________ City, State, Zip:_________________________________ Phone #:______________________________________ Quantity------------------------Item#-----------------------------Price ________|___________________________________|__________ ________|___________________________________|__________ ________|___________________________________|__________ _____________________________________subtotal__________ _________________FL residents add 7% Sales Tax__________ ____________________________________Add S&H__________ ________________________________________Total__________ Sorry, no personal checks. Cert. Funds/ MO's OK. Please remit to:Kurt V. Wala 6167 S.E. 26th St. Suite A Bushnell, FL 33513