Send orders accompanied by payment to: Four Pi, Inc. 4944 N. Orange Ave. Norridge, IL 60706-3224 ORDER FORM SHIP TO: Name________________________________________________________________________ Address_____________________________________________________________________ City__________________________________________State_______ZIP_______________ Day Phone___________________________Eve Phone_______________________________ PRICE TOTAL LEAVE QTY | STOCK # | DESCRIPTION | EACH | PRICE | BLANK | | | | | | | _______|_____________|_________________________________|_______|_______|_______| | | | | | | _______|_____________|_________________________________|_______|_______|_______| | | | | | | _______|_____________|_________________________________|_______|_______|_______| | | | | | | _______|_____________|_________________________________|_______|_______|_______| | | | | | | _______|_____________|_________________________________|_______|_______|_______| | | | | | | _______|_____________|_________________________________|_______|_______|_______| | | | | | | _______|_____________|_________________________________|_______|_______|_______| | | | | | | _______|_____________|_________________________________|_______|_______|_______| | | | | | | _______|_____________|_________________________________|_______|_______|_______| | | | | | | _______|_____________|_________________________________|_______|_______|_______| | | | | | | _______|_____________|_________________________________|_______|_______|_______| | | Sub-Total |_______| | | Illinois Residents Add 8.75% Sales Tax |_______| | | Shipping & Handling (see below) |_______| | | TOTAL ENCLOSED |_______| USA Shipping & Handling Up to $40.00 - Add $5.00 $40.01 to $60.00 - Add $8.00 $60.01 to $80.00 - Add $10.00 $80.01 to $100.00 - Add $12.00 $100.01 and over - Add $15.00 Contact us by e-mail for overseas shipping costs.