YOUR MAILING ADDRESS:
NAME:___________________________________________________________________
ADDRESS:________________________________________________________________
CITY:______________________________ STATE:_____________ ZIP:______________
HOME Telephone Number: ________-__________________________
WORK Telephone Number: ________-__________________________ (optional)
E-mail:___________________________________________________
______ ________________________________________________ ________ ________
______ ________________________________________________ ________ ________
______ ________________________________________________ ________ ________
______ ________________________________________________ ________ ________
______ ________________________________________________ ________ ________
SUB TOTAL ........................... $ ________
!! New York State Sales Tax... (8%) .... $ ________
** Shipping ............................ $ ________
++ TOTAL PAYMENT........................ $ ________
PRODUCTS:
!! For New York State residents only.
QTY DESCRIPTION PRICE PER TOTAL
** If unsure about shipping fees please contact me.
++ Please make payment out to STONY BROOK COMPANY