Order Form - C&A of Texas

Please send check, money order, or MC/Visa information to:

C&A of Texas
8524 Hwy 6N #105
Houston, Texas 77095

Or if you prefer, you can place your order via e-mail using the form listed below:

Quantity of "Texas Koozies" @ $14.95 USD

Quantity of "Texas Coasters" (set of four) @ $9.95 USD

Enter up to Three (3) Initials free of charge on your Koozie. Add $.50 for each additional letter.

Total Purchases, Quantity X amount - Enter in USD

8.25% Sales tax (TX Residents Only), Total Purchases X 8.25%

Total Shipping & Handling

Up to 14.99 add $3.50 US

$15.00 to $29.99 add $4.50 US

$30.00 to $49.99 add $5.00 US

Over $50.00 add $6.00 US

Grand Total

Name of Purchaser

Company Name

Shipping Address (Line 1)

Shipping Address (Line 2)

City or Town

State

Postal / Zip Code

Country (if not USA)

Visa
Mastercard

Credit Card #

Expiration Date

A/C + Phone

E-mail Address

Please send check, money order, or MC/Visa information to: C&A of Texas 8524 Hwy 6N #105 Houston, Texas 77095 Or if you prefer, you can place your order via e-mail using the form listed below:

WEScomp,Inc. All contents copyright (C) 1996, WEScomp, Inc. All rights reserved. Revised: November 10, 1996 URL:http://www.wescomp.com/cat

Please send check, money order, or MC/Visa information to:

C&A of Texas
8524 Hwy 6N #105
Houston, Texas 77095

Or if you prefer, you can place your order via e-mail using the form listed below:

WEScomp,Inc.

All contents copyright (C) 1996, WEScomp, Inc. All rights reserved.
Revised: November 10, 1996
URL:http://www.wescomp.com/cat