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Please send:

______ set(s) of labels @ $895.00                        $_______

       Zip region #'s  _________________,

       (      ) @ 9.5 ea  [call for count]               $_______


                                             Subtotal     _______

                     (CA res. only)  7.75%  sales tax     _______

                               Priority Domestic S&H     $   5.00
                                                          _______

                    Foreign Postage & Insurance extra     _______

                                               Total     $_______


My check for $________ is enclosed or

Please charge to my:

[  ] VISA    [  ] MasterCard    [  ] AmEx


# ________ ________ ________ ________ exp ___/___


_________________________________________________
Name as it appears on card (Please print)


Signature _______________________________________


SHIP TO:

Name:      ______________________________________

Address:   ______________________________________

           ______________________________________

City:      ____________ State: ____ Zip: ________

Phone #:   (_____) ______________________________

Email:     ______________________________________