Index

Please Print Order Form

Mail, Phone or Fax your order to:
RT-DESIGNS USA
P.O.Box 2061, ~ Salisbury, NC 28145-2061
Phone (704) 279-9301~~~~~Fax (704) 279-8019
Email = RTDesignsUSA@gmail.com ~~~~~Web = www.RobertToth.com/

Shipping & Handling
Up to $100 add $12 .
$101.-$150. add $15 .
$151.-$200. add $17
$201.-$250. add $20.
$251.-$300. add $22.
$301.-$350. add $25 .
$351.-$400. add $27.
$401.-$450. add $30.
PART NUMBER DESCRIPTION QTY $ EACH $ TOTAL
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$ $
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Total
Shipping and Handling
North Carolina Residents Add Sales Tax
Total Enclosed

Please Print Shipping Address - Please print NAME as it appears on CREDIT CARD.

NAME__________________________________________PHONE_________________________

ADDRESS__________________________________Email________________________________

CITY_____________________________________ST_______ZIP______________
....................................................................................................................................
CREDIT CARD, Check one..............|.....................Make checks payable to RT DESIGNS USA
VISA|___|..... MC|___|..... Exp. Date____________________________

CARD #_____________________________________________________| 3 Digit Code (Back of Card) _________


Signature__________________________________________________Date______________
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