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MAXIS MINIS order form    

www.maxisminis.com

 

       Please Print                                                                  Send Order to:

Name________________________________                                   Max Fields

Address______________________________                              182 N. Walnut Dr.

State & Zip___________________________                              Greenfield, IN 46140

Phone #______________________________                    e-mail: max@maxisminis.com

e-mail________________________________

Qt.

Stock #

Description

Unit Price

   

Extended Price

 
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               

Method of Payment

Merchandise Total

   

Sorry no C.O.D,'s

FREE POSTAGE

00

  00

 Check or Money Order Payable to Max Field

O Check to Pay by PayPal invoice

Indiana Residents add 7%sales tax

   
Visa    Master Card      

TOTAL

   
Card # _____   _____   _____   _____
Expiration Date______/______
Name on Card
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Signature: