Gift Order, or Ship To: (only if not the same)
Name:__________________________________
Address:___________________________________
City/State/Zip:_____________________________________________
Phone: (..........) ___________________

Quantity

________# MAGK1 ($12.00 each).....*......Total__________
________# MAGK2 ($2.99 each).......^......Total__________
________# MAG25A($22.25 each)....*......Total__________
________# MAG252 ($29.00 each)....*......Total__________

Sub Total.............................................................__________

Tax: Add %8 Sales Tax if ordered in NY State...__________

Shipping: $2.00 per item, plus $3.00 per order, up to $12 Maximum

Grand Total........................................................__________

Visa / Mastercard Orders:

Card Number:   ____________________________________
Expiration Date: __________
Security Code : __________
(last three digits of the number on the back side of the card)