USA ORDER FORM

( * = Required Item )		*DATE:
*NAME:		*E-MAIL ADDRESS:
*SHIPPING ADDRESS:
*CITY:	*STATE:	*ZIP CODE:	*PHONE:

ITEM #	TITLE OR DESCRIPTION (Include color choice if ordering I.D. Cards)	HOW MANY	PRICE EACH	TOTAL PRICE

POSTAGE RATES	*Merchandise Total
(Continental United States)	Coupon Number  Minus Amount
(INCLUDES  INSURANCE)	Sub-Total
$10.00 to $25.00 ------------- $ 7.00	*Postage
$25.01 to $50.00 ------------- $ 9.50	*Total Due
$50.01 to $100.00 ----------- $15.00	Write the TOTAL DUE amount down, you'll need it to add to the Payment Page!
$100.01 to $150.00 ---------- $17.50
$150.01 to $200.00 ---------- $19.00
Over $200.01 --------- 9% of Order	MINIMUM ORDER: $10.00
Alaska, Hawaii and U.S. Territories: Double Above Rates

PAYMENT BY CHARGE OR DEBIT CARD THROUGH PAYPAL ONLY.
(You will be directed there after you submit this form.)

How did you find out about SciFiGoodies.com? 


If you want a copy of this filled in order form for your records, PLEASE print it BEFORE pressing the "SUBMIT" button!