CHECK OR M/O NUMBER:________________________________DATE:__________________
NAME:__________________________________________________________________________
ADDRESS:_______________________________________________________________________
SHIP TO:________________________________________________________________________
ADDRESS:_____________________________________________ZIP:______________________
QUANTITY *** ITEM NUMBER ************* DESCRIPTION *************** COST **** EXT.****
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ADD TOTAL FOR ORDER:______________________________________________________________________________
PACKING / SHIPPING CHARGES, (CHART BELOW):________________________
These charges represent only a part of the actual costs. We'll pay the rest. If your order is:
UP TO $14.99,-----------------ADD $4.05
FROM $15.00 TO $19.99---ADD $4.35
FROM $20.00 TO $24.99---ADD $4.65
FROM $25.00 TO $29.99---ADD $5.45
FROM $30.00 TO $34.99---ADD $6.05
FROM $35.00 TO $39.99---ADD $7.00
FROM $40.00 TO $44.99---ADD $7.80
FROM $45.00 TO $49.99---ADD $8.60
OVER $50.00 -------------------ADD $9.10
TOTAL ORDER PLUS SHIPPING:----------------------------->>>>>$____________________________________ENCLOSED
MAIL TO:
S & L QUALITY DISCOUNT MERCHANDISE
P. O. BOX 508
BELTON, SOUTH CAROLINA 29627