Order Form

Please Use This Form to Mail/Fax Your Order

Name (Please Print or Type):

Mailing Address:

Street:

City:

State:

Zip Code:

Home Phone:

Work Phone:

Shipping Address: Check if same as above:

Street:

City:

State:

Zip Code:

Home Phone:

Work Phone:


	For Subtotal	Handling Fees:
Make Check or Money Order Payable to OMTA	$0 - $9.99 $10.00 - $49.99 $50.00 - $99.99 $100.00 - $199.99 $200 and above	$4.50 $5.00 $11.00 $13.00 $16.00

Your E-mail address:_____________________________________

Sub Total
<------Please add Handling Fee
Do you live in TX? Please add 6.25% sales tax
ORDER TOTAL

Ordering By Mail?
Mail this Form to:
Old Mobeetie TX Assn.
P.O. Box 66
Mobeetie, TX 79061
USA

Phone, Fax Order Line or Questions
1-5 PM CST only: 1-806-845-2028

Closed on Wednesdays

E-mail and Web Catalog Orders:
www.mobeetie.com
e-mail: sales@mobeetie.com