Ellistrations Order Form

PRINTABLE ORDER FORM PAGE

If you do not wish to order by Credit Card just print out this form and fill it out. Then send it with a check or money order to:

Ellistrations,

3836 Walhampton Dr.

Lexington, KY 40517

(859) 271-9973

mark.ellis@insightbb.com

Name:_________________________________________________________________

Address:___________________________________________________________

____________________________________________________________________

 

State:___________________________________Zip Code___________

Country______

 

Email Address_____________________________________________________

Home Phone (optional)____________________________________________

Business Phone(optional)____________________________________________

 

Items Purchasing

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Item______________________________________________Size _______Price____________

Item______________________________________________Size _______Price____________

Item______________________________________________Size _______Price____________

Item______________________________________________Size _______Price____________

Item______________________________________________Size _______Price____________

Item______________________________________________Size _______Price____________

Item______________________________________________Size _______Price____________

_____________________________________________________________Total____________

Please add $5.00 US Dollars for Shipping in the United States and Canada. Foriegn Countries should add $10.00 for shipping by boat or $8.00 for shipping by Air.

Please add an additional $1.00 for each additional item for shipping

If you do not hear from us or receive your product in 3 weeks, please contact us!

mark.ellis@insightbb.com