BILLING ADDRESS:
O
Home O
School SHIPPING ADDRESS:
O
Home O
School
_______________________________________ ________________________________________
School or District School or District
_______________________________________ ________________________________________
Name (Dr., Mr., Mrs., Ms.) Name (Dr., Mr., Mrs., Ms.)
_____________________________________ ________________________________________
Address Address
_______________________________________ ________________________________________
City State ZIP City State ZIP
_______________________________________ _______________________________________
Phone Fax Phone Fax
_______________________________________ _______________________________________
E-mail
E-mail
PAYMENT METHOD: DATE ORDERED:___________________
O Purchase Order No. _____________ PLEASE ALLOW UP TO 6 WEEKS FOR DELIVERY
(Must be attached)
O Check
MAIL ORDERS TO: Cupp Publishers, Inc.
52 Wylly Avenue
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Catalog # |
Title/Description |
Quantity |
Unit Price |
Total |
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Subtotal |
$ |
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Shipping/ HandlingUnder $100 $10 $100-$1,000 10% Over $1,000 8% |
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Shipping and Handling |
$ |
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Sales Tax (if applicable) |
$ |
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Total |
$ |