NAME:___________________________________	DATE:____________
ADDRESS: ________________________________
CITY:_____________________________________	STATE:______	ZIP:__________
TELEPHONE:_______________________________

TERMS AND CONDITIONS

$ 10.00 is the minimum order before shipping charges. You may oay by check or money order in U.S. funds drawn on a U.S. bank.. Please be aware that orders paid by check will be held until the check clears the bank. This can take anywhere from 2 to 4 days depending on your location. Major credit cards will be accepted through Ocean State Electronics, our exclusive distributor pictured on the next page. ADD $10.00 SHIPPING AND HANDLING PER KIT.

SUB TOTAL: ____________________ DISCOUNT (IF APPLICABLE): _____ MASS ONLY 5% SALES TAX: ______ SHIPPING & HANDLING: _________ TOTAL: ________________________