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Form can be used as a Fax (435-687-9239) or for USPS Orders |
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| Today's Date: | ||
Year & Body Style of Car: |
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| Your Name: | ||
| UPS ship to/Del. address | ||
| City/State/Zip | ||
| AC & Phone# | ||
| PRINT Your EMAIL address: | ||
| Card Billing Name: | ||
| Card Billing Address: | ||
| Card City/State/Zip: | ||
| Card AC & Phone: | ||
We accept Visa, MasterCard, Discover. Place the 16 numbers below & Expiration date. |
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| _____________/______________/_______________/________________/exp.______/_______ | ||
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Please sign your name here:________________________________________V-Code______ |
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Name of Part |
Item # |
Price of Part |
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Sub-Total |
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Shipping |
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| MADE IN THE USA~Total Amount Due USA FUNDS ONLY $ | ||
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We pay UPS ground on FULL WOOD KITS in the 48 states. You pay for UPS for individual items. Please see our FAQ's page for Returns and other important information. |
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Utah residents must pay 6.35% sales tax |
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