Print form, fill out and mail with payment to address below
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Name: 
Address: 
City, State, Zip: 
 Item Description:  Color: Size: Quantity: Price Each: Total Price:
           
           
           
           
           
ALL ITEMS
$3.00 for first item and .50 cents for each additional item		 Shipping &
Handling:		  
Sub Total:  
Texas Residents Only Add 6¼% Sales Tax:  
Grand Total:  
Method of Payment:
DO NOT SEND CASH		 Check____  Cashier's Check____  M.O.____  Discover____
DISCOVER CARD - PLEASE PRINT
Name on Card:		 
DISCOVER CARD
Card Number:		 
DISCOVER CARD
Expiration Date:		 
Make Check or Money Order
Payable To:
Photon   Willie
Mail To: Photon Willie - Webmaster
(Street)
(City, State, Zip)
Allow 4 - 6 weeks for delivery ..... THANK YOU FOR YOUR SUPPORT !
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