Steve Sarmiento PLEASE NOTE THAT MAIL ORDERS TAKE CONSIDERABLY LONGER P.O. BOX 9 Newbury, OH 44065 Thank you for your order. Please print out the form, fill it out accurately and send it to the address above. Sorry but you have to do the math :) Thanks again, Steve (make checks to Steve Sarmiento) Date:___________________________ Name:___________________________________ Address:_____________________________________________ _____________________________________________ _____________________________________________ Phone:___________________________________ E-mail Address:___________________________________ How you heard of YoSteve:__________________________________________ Special Instructions:______________________________________________ ___________________________________________________________________ Towels Price x Quantity = Total ___________________________________________________________________ 1 Ultra Towel : $8.89 x ________ = ______________ 3 Ultra Towels : $23.99 x ________ = ______________ 5 Ultra Towels : $38.25 x ________ = ______________ 10 Ultra Towels : $68.95 x ________ = ______________ 2 Mini MF-Towels (4"x4"): $2.99 x ________ = ______________ ___________________________________________________________________ Mini-Kits Price x Quantity = Total ___________________________________________________________________ Klasse Sample Kit (US Order) : $ 15.85 x ________ = ______________ Klasse Sample Kit (Canada Order) : $ 16.35 x ________ = ______________ ___________________________________________________________________ Applicators Price x Quantity = Total ___________________________________________________________________ Applicator Kit : $6.99 x ________ = ______________ 2-MF covered applicators 2-yellow foam applicators 3-MF covered sponges : $6.50 x ________ = ______________ 3-yellow foam applicators : $4.50 x ________ = ______________ ___________________________________________________________________ Miscellaneous Price x Quantity = Total ___________________________________________________________________ pair of 1 oz squeezable mini-flip top bottles $4.50 x ________ = ______________ 10 pairs of vinyl gloves $4.35 x ________ = ______________ ___________________________________________________________________ I suggest, Canada orders add $5 USD for global priority shipping (not required) Grand total (US Dollars Only) : = ______________