BMJR Models Retail Order Form

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SHIP TO: (Please Print)

Name:__________________________________________ Address:___________________________________________ Address:___________________________________________ City:_______________________State:______Zip:________Country:_______

Qty.                           Stock #                                          Description                             Price _______/_________/_________________________/_________ _______/_________/_________________________/_________ _______/_________/_________________________/_________ _______/_________/_________________________/_________ _______/_________/_________________________/_________ _______/_________/_________________________/_________ _______/_________/_________________________/_________ _______/_________/_________________________/_________ _______/_________/_________________________/_________ _______/_________/_________________________/_________

                                                   Sub Total_________
             Florida Residents add 6% Sales Tax ________
                                                               Shipping ________
                                         Grand Total_________
MC _____    VISA _____ Card No. ____-____-____-____ exp. __ / __

* SHIPPING CHARGES
U.S./Canada orders shipped US Priority Mail $5.00   1 Item
$1.50   Each add'l item
International orders shipped Air Mail $12.00 1 Item
$5.00   Each add'l item
Mail with Check or Money Order To:

BMJR Model Products
P.O. Box 1210
Sharpes, FL  32959-1210