BILL TO ADDRESS

SHIP TO ADDRESS - if different than bill to

Phone #
 

Phone #
 

Email # (to email your order confirmation)  
 

Item #

Size / Description / Style / Color: 1st & 2nd Choice

Price

Qty

Total

Payment: Check / Money Order/ Master Card or VISA

Sub Total

Credit Card #

Exp. Date:

IL residents sales tax 7%

Name as it appears on card:
 

Shipping on Saddle  $30.00 (USA)
Shipping on orders up to $100.00 is $10.00   

Last 3 numbers on back of card by your signature:
 

Shipping for orders over $100.00 add 7% of total. ($10.00 minimum)
Call For questionable shipping charges
TOTAL

Your signature: