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Print form and mail to:
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Hiller Productions
W7038 Farmers Grove Road
Monticello WI 53570 |
Name:
________________________________________________
Address:
______________________________________________
City,State, Zip:
__________________________________________
Phone #:
_______________________________________________
Email:
_________________________________________________
If you need more space, use back of form or another
sheet of paper.
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Quantity |
Item # |
Production Title/Description |
Price Each |
Total |
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Merchandise Total __________
Sales Tax 5.5% (only if you live in
Wisconsin) __________
Sub-Total __________
Add Postage and Handling Charges from
the chart below __________
TOTAL ENCLOSED __________
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PAYMENT METHOD: Payment must be made in US
Funds.
____ Check ____ Money Order
____ MasterCard ____ VISA ____
American Express ____ Discover
Credit Card Number:
_____________________________________
Expiration Date (MM/YY):
________________________________
Thank you!
SHIPPING & HANDLING CHARGES:
| TOTAL ORDER |
USA |
CANADA |
FOREIGN COUNTRIES |
| Up to $11.99 |
$ 5.00 |
$ 6.00 |
$13.00 |
| $12.00 to $44.99 |
$ 7.00 |
$11.00 |
$15.00 |
| $45.00 to $69.99 |
$ 9.00 |
$13.00 |
$17.00 |
| $70.00 to $99.99 |
$11.00 |
$15.00 |
$19.00 |
| Over $100.00 |
$12.00 |
$16.00 |
$20.00 |
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