Watkins US Customer Order Form
Customer Name_____________________________________________
Address___________________________________________________
City________________________State____________Zip____________
Day Phone (____) ______________ Evening Phone (____) ___________
Ship to address, if different from above.
 Address___________________________________________________
City________________________State____________Zip____________
Article No.
Quantity
Description
Price Each
Total
         
         
         
         
         
         
         
         
Shipping and Handling

US & CN:
$0.00 to $50.00 = $9.95
$50.01 to $100.00 = $12.95
$100.01 to $149.99 = $14.45
Over $150.00 = FREE

For shipment to Alaska, Hawaii, Guam, Virgin Islands or
Puerto Rico, on orders under $150.00 shipping/handling charge is amount shown above, plus add $1 for each unit ordered that shows the shopping cart icon.

Total for Items _________
Add applicable state, city, & local tax ________
If you have questions on appropriate tax, please call 1-800- 243-9423 and they will help you.

Shipping and Handling _________
    
TOTAL _________

Send To:
WATKINS INC.
DEPT QS
P.O. Box 5570
Winona, MN 55987-0570
 HOW YOU WISH TO PAY
( ) Check or Money Order, Payable to Watkins
( ) Visa ( ) Master Card ( ) Discover
Sorry, No C.O.D. or cash orders
 Card Number ___________________
Exp. Date_______
Signature:
Watkins
Representative

Karen Goodale
#138048