|
Printable Order Form |
|
Angi-B & Company
PO Box 3015
Clinton, IA 52732
563-243-1151 fax/phone |
|
Name |
|
Date |
|
Street |
|
Phone |
|
City |
|
[ ] Check [ ]
Money Order |
|
State |
|
[ ]Visa
[ ] Mastercard
Exp Dte |
|
Zip |
|
Card #'s |
|
e-mail |
|
Signature |
|
Item # |
Qty |
Description |
Price |
Total |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Special Instructions: |
Subtotal |
|
|
Shipping
10% (minimum$2) |
|
|
(IA Only) 6% |
|
|
Grand Total |
|
|
