Phone: 877-813-9663
				Master Stripe Fax-Mail Order Form
			Or Mail To:	Master Stripe
				PO Box 1091
Please Fax To: 608-784-8770				La Crosse WI 54602
				Phone: 877-813-9663
				e-mail: orders@masterstripe.com
Company or Full Name				Attention
Shipping Address (no PO Boxes if shipping via UPS, please)				Department/Suite
City			State/Province	Zip/Postal Code	Country
Phone				Email (required)
ORDER INFORMATION
Part # Description                               Color/Pattern                        Quantity                 Price
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Please use another copy of this order form if additional products are required
				Minnesota add 7% Sales Tax
				Wisconsin add 6% Sales Tax
				Add Shipping  $8.00
PAYMENT METHOD:				Free Shipping (if over $200)
				Deduct 5% from order if over $300
VISA	M/C           AMERICAN EXPRESS
				SUBTOTAL
Card Number:                                                                             Exp.
Signature: