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BROOKS PRODUCTS & SERVICE
P.O. BOX 2249
LYNNWOOD, WA 98036-2249
ORDERED BY: (Please Print)

Name: ___________________________________________________

Street Address or P.O. Box (include apartment #):

   ___________________________________________

   ___________________________________________

City: _______________________ State: _______ ZIP: ________

Home Phone: ______________________

E-Mail:     ______________________

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Make Payable to
Brooks Products
o VISA
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Acct #:
_____________________
Expiration Date:
_____ / _____
Signature (required)
_____________________
QTY COLOR SIZE DESCRIPTION PRICE
EACH
TOTAL
PRICE
           
           
           
           
           
           
           

U.S.A. SHIPPING/HANDLING CHARGES:
Under $30.00....... $9.00
$30.00 to $95.00... $13.00
Over $95.00........ FREE*

*(Retail sales in U.S.A. only)

OUTSIDE OF U.S.A
SHIPPING/HANDLING CHARGES:
CANADA:

Under $30.00....... $12.00
$30.00 to $95.00... $18.00
$95.01 and up...... $22.00

ALL OTHER COUNTRIES:
Under $30.00....... $25.00
$30.00 to $95.00... $32.00
$95.01 and up...... $42.00
Sub Total  
Add 9.5% Sales Tax on Shipments to WA  
Shipping & Handling  

(Payable in U.S. Currency Only) TOTAL

 

Thank you for your order!


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