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Full Name
______________________________________________________________
E-mail _________________________________________________________________
Address 1
________________________________________________
Address 2
______________________________________________________________
City._______________________________
State ___________ Zip ________________
Home Phone.
______________ Work
Phone _______________ Fax ______________
If paying
by check, please provide references: preferably a nationally known
dealer or auction house. If references are not nationally known,
please provide their contact information.
Reference
1: ______________________________
Reference
2: ______________________________
[ ] CSA membership
number _____________
[ ] APS membership
number _____________
[ ] USPCS membership number __________
[ ] Other,
membership number __________
Item number
___________ Brief description ______________________________________
Price _____________
Item number
___________ Brief description ______________________________________
Price _____________
Item number
___________ Brief description ______________________________________
Price _____________
Item number
___________ Brief description ______________________________________
Price _____________
Item number
___________ Brief description ______________________________________
Price _____________
Sub-total
_____________
Discount _____________ See Ordering
and Sales Policies
Shipping _____________ See Ordering
and Sales Policies
Total ________________.
[ ] I will
send check or money order in U.S. funds.
[
]  I
prefer to pay with PayPal/credit card. Please email me an invoice.
[
] I have read, acknowledge and understand
the Terms and Conditions of sale: Ordering
and Sales Policies
All
orders will be acknowledged. If you don't get an acknowledgment
within 24 hours, I didn't receive the order for whatever reason.
If that happens, please call or try direct e-mail.
I
apologize that this is not an interactive order form, but my web
host server does not seem to be able to provide a form that works
100% of the time.
Hyperlinks (hot links) are also no longer used on this website
in order to cut down on spam. Email addresses are provided in
graphic format, thus you cannot "click" to use. You
must type out the information.
Remit orders
to:
Patricia A.
Kaufmann
10194 N. Old State Road
Lincoln, DE 19960
Phone: (302)
422-2656
Fax: (302) 424-1990
E-mail:
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