Sheepskin.com Text Only On-Line Order Form Mail or Fax this Form to: Sheepskin.com 6018 234th Street SE, Suite C Woodinville, WA 98072 Fax - (425) 672-3958 Daytime Phone # ___________________________ Evening Phone # ___________________________ Billing Address Name ______________________________ Address ______________________________ City, State ______________________________ Zip _________________ ENTER YOUR EMAIL ADDRESS ___________________________ Ship To (if different from billing address) Should we treat this as a gift? ____ Gift wrap and enclosure $5.99 additional. Should we add to your order? Yes No Name ___________________________________ Address ___________________________________ City, State ___________________________________ Zip _______________ Gift Message _________________________________________ Sheepskin.com Products Quantity | Item Number | Size | Color | Description | Item Price | Total | _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 1. Total cost of items:_______________ 2. Shipping from table below:_________________ 3. Subtotal of 1 + 2 above _______________________ Sales tax = Subtotal(3) times 8.9%__________________ (WASH STATE RES. ONLY) Grand TOTAL:__________________________ Method of Payment:[] VISA [] MasterCard [] Discover [] AMEX [] Check or [] Money Order Bankcard Number___________________________________/____________ ACCOUNT NUMBER EXP. DATE Issuing Bank _________________________________/3 Digit Security PIN# from back of card(AMEX 4 digit front of card) _________ Signature (Required) _____________________________________________ Shipping & Handling Charges: Ground Shipping Charges Order Total U.S.A. Hawaii & Alaska Under $15 $8.50 $9.95 $15 to $24.99 $9.55 $12.95 $25 to $49.99 $10.99 $18.00 $50 to $74.99 $11.99 $24.00 $75 to $99.99 $13.99 $34.00 $100 to $149.99 $17.99 $40.00 $150 to $199.99 $22.99 $45.00 $200 to $299.99 $26.99 $55.00 $300 to $349.99 $31.99 $65.00 $350 to $399.99 $35.99 $75.00 $400 to $499.99 $38.99 $85.00 $500 to $599.99 $44.99 $95.00 $600 to $699.99 $51.99 $105.00 $700 to $799.99 $73.99 $120.00 $800 to $899.99 $79.99 $150.00