Order Information

Print your form, call or send your form, with money order to:

Tim Weber
P O Box 223
Aurora, In.47001

To use a credit card, please call 812-926-4677.

For further information, questions, E Mail: Tim Weber or Phone: 812-926-4677
Name:
Address:
City:	State:Zip Code:
Country:
Email:
Phone: Daytime:	Night-time:
NOTE: Telephone number or email address MUST be included so that we may contact you the night prior to shipment.
Date Wanted:

	Sub-Total: ___________
Please call for shipping to your area	Postage & Handling: ___________
Thank you for your order!	Total Amount Due: ___________

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