
| Ship
To :
Name: |
|||
| Address: | |||
| City: |
St: |
Zip: | |
| Phone: | Fax: | ||
| Stencil Number | Description | Quantity | Price | Total |
|
Subtotal |
|
|
Sales Tax ( Texas Residents Only X .0825) |
|
|
Shipping and Handling |
$3.00 |
|
Total Amount |
| School Purchase Order No: | ||||
| Check or Money Order Enclosed: | ||||
| Charge To: | Visa | MasterCard | Discover | American Express |
| Account No: | ||||
| Signature: | ||||