Madmins Order Form

To:
   Madmins Limited
   3202 Douglas Woods Drive
   Urbana, IL 61802

Please print out this form, fill in the necessary information,
and then send it to the address at right.

First name: ______________________ Last name: __________________________

Address: ___________________________________________________________

City: ______________________ State/Province: __________ Zip: _______

Country: _____________
Email: _______________________________

Item # Quantity Price Price * Quantity

CAT509 ____ $34.95 _________

CAT509P ____ $49.95 _________

________________ ____ ________ _________

________________ ____ ________ _________

subtotal: _________

shipping: _________

Add $4.00 for the first item,
plus $1.00 for each additional.

Total enclosed: _________

Policies:

Enclose a personal check (or cheque), bank draft, or money order drawn in U.S. Dollars

We really suggest that you do not send cash through the mail.

Please allow 4-6 weeks for delivery.

At this time, we cannot accept COD orders.

Standard shipping will be USPS Priority Mail. If you desire alternate shipping arrangements, please note them below on this sheet. (Be certain to add sufficient shipping to the Total.)

We will email you to acknowledge receipt of your order, and again when your order has been shipped.

Remember our URL: http://www.roadkill.net/madmins/

First name:	______________________	Last name: __________________________
Address:	___________________________________________________________
City:	______________________	State/Province:	__________	Zip:	_______
Country:	_____________
Email:	_______________________________

Item #	Quantity	Price	Price * Quantity
CAT509	____	$34.95	_________
CAT509P	____	$49.95	_________
________________	____	________	_________
________________	____	________	_________
		subtotal:	_________
		shipping:	_________
	Add $4.00 for the first item, plus $1.00 for each additional.
		Total enclosed:	_________