ORDER PAGE
Visick's Innovations for the twentyfirst century - Jigsay puzzling, home dental care, carpet savers for guests.

1. UPS or FEDEX GROUND ONLY
2. No delivery to P.O. Box or General Delivery
3. Delivery ony to physical address

This page is a printable order form for mailing to:

Print, fill out form and mail to:
Burke Waldron
3060 NE McWilliams Road #113
Bremerton, WA 98311

PUZZLE LOVERS DREAM      

QUANTITY
PRICE EACH
SHIPPING EACH




$159.00 $24.95    


HOME DENTAL CARE MINIMUM ORDER - 2 PAIR  


QUANTITY
PRICE/PAIR
SHIPPING EACH

  S - CHILD OR WOMEN   $1.95 $0  
  M - MEN   $1.95 $0
  L - MEN LARGE   $1.95 $0


CARPET SAVERS  (10 PAIR PACKS)       

NO. PACKS
PRICE/PACK
SHIPPING EACH




$18.48 $0


        SUBTOTAL $
    WASH. STATE RESIDENTS: Add 8.5% sales tax TAX $
        TOTAL $

ALLOW 10-14 DAYS


SHIP TO:
NAME
ADDRESS




CITY
STATE
ZIP
PHONE






CREDIT CARD: VISA     MASTER CARD     DISCOVER     AMERICAN EXPRESS
ADDRESS CARD NO:
EXP.
CITY NAME OF THE CREDIT CARD HOLDER