Direct Orders:
This section of our online store is intended for check or money order purchases. If you wish to purchase using your credit card return to the previous page and click the "Place an ONLINE order" button. To submit an order by mail complete this printable mail order form and send it to us with your payment enclosed. To minimize the wait associated with check or money order purchases we advise you to complete and submit the form below to allow us to begin processing your order. Orders submitted using this form will be shipped once payment has been received. Complete and submit the form below to place an order:

*Shipping Information:

*Name (First & Last):
Company Name:
*Email Address:
*Address:
*City:  *State:  *Zip:
*Day Phone:  Evening Phone:
Questions/Comments:

*Order Information:

ITEM NAME PRICE QUANTITY TOTALS
Power Wedge 1000 $19.95 each
       
Add Applicable shipping charges (UPS or U.S. Postal Service): $6.00
SubTotal:
Louisiana Residents add 4% state tax to SubTotal:
Grand Total:

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PLEASE NOTE: Asterisks "*" indicate information that is required for the successful submission of this form.
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