Magnifiers Offline order form

Magnifiers order Page

Please Check the appropriate box below
After you have filled out the form "Please Print It" and Submit
You will receive a E-mail or Phone Call to confirm your order within 24 hours & give you a total for your purchase

I will send a Check or Money Order	I will call your Sales Department at 888-243-6040 with Credit Card Info	I would like to place a special order

M101 Black & Silver
M102 Tortoise
M103 Silver Plate Chain
M104 Pearl

Shipping Options

Free Standard Shipping
Priority Shipping	$4.00 Extra
Express Shipping	$16.00 Extra (Call to confirm availability)

GENERAL INFORMATION

First Name:	Last Name:
Address:
City:	State: Zip:
Country:
Phone Number:
E-Mail Address:

Be Sure to check out other fine Products at www.amtraco.com