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TO MAIL:...Print,
      fill out, and mail to:...Whitfield Jack, Inc... PO Box 5905...Key West, FL 33045
 
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  Description
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Subtotal "A"
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Florida Residents Add 7.5%.
 
Sales Tax
 
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Subtotal "B"
 
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Postage (Find Rates Below)
 
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 NOTE: Calculate
      postage based on amount In Subtotal "A"

      
 Total
 
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Click for U.S. Postage
            Rates 
 
          
Click
            for Canadian Postage Rates
 
          
Click
            for Overseas Postage Rates
 
        
      

        

          
Name
 
          
 
           
        
        

          
E-mail and Phone
 
          
E-mail:
 
          
Ph:
 
        
        

          
Billing

            address
 
          
 
           
        
        

          
Shipping

            address,

            if different
 
          
 
           
        
        

          
Card
 
          
___Visa. ___MasterCard. ___Amex
 
          
 Sec. Code:
 
        
        

          
Card# & Exp.
 
          
.
 
          
 Exp: M/Y
 
        
        

          
Name on Card
 
          
 
           
        
      

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