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:

Item
Qty.
Price
Total




































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

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