|
Name
|
________________________________________________________
|
||||
|
Company
|
________________________________________________________
|
||||
|
Address
|
________________________________________________________
|
||||
|
________________________________________________________
|
|||||
|
City
|
________________
|
State
|
_____
|
Zip Code
|
________
- _____
|
|
Phone
|
________________
|
E-mail
|
____________________
@ ________________
|
||
|
Joint Function
GL Orders
|
|||||
|
Quantity
|
Product
|
Price Each
|
Total
|
||
|
________
|
Joint Function
GL - 3.5 oz Tube
|
$16.99
|
$
|
||
|
________
|
Shipping &
Handling
|
$2.50
|
$
|
||
|
Gator
Gubba Lip Balm Orders
|
|||||
|
Quantity
|
Product
|
Price Each
|
Total
|
||
|
________
|
Gator Gubba
- Pineapple Vanilla
|
$1.25
|
$
|
||
|
________
|
Gator Gubba
- Watermelon
|
$1.25
|
$
|
||
|
________
|
Gator Gubba
- Cherry
|
$1.25
|
$
|
||
|
________
|
Gator Gubba
- Bubble Gum
|
$1.25
|
$
|
||
|
Order Totals
|
|||||
|
Tax (7% - Ohio
Residents Only)
|
------>
|
$
|
|||
|
Total
Amount Due
|
------>
|
$
|
|||
