AstroElectric Order Form
http://www.4SaleUSA.net/AstroElectric


email to: >>> mikecr at cfl.rr.com <<< cut and paste the email address into your email

PayPal payment is avaiable, email me and I will send you a PayPal Request for Payment. Please include your name address and Phone number in email.
OR by mail with a Money Order

Can ship to International Address
Please printout and fill out for proper processing

Date_________________

Name________________________________

Address ________________________________________

City _____________________ State _________ Zipcode__________

Country_____________________

Phone #___________________________

Email address________________________@______________________

EMAIL ADDRESS NOTE
---Only if you want to be notified about your order, I don't keep a list of email addresses, this is only to notify you that your order has been received and shipping. That's the reason. You will never get a spam email from AstroElectric!!!!! If you ever receive a spam email from AstroElectric please notify me and I will handle it. From time to time, spammer hijack email addresses on the web and sent spam, again please notify me. Thanks <\font>

I wish to Order the following items

Dimmer Controller..................... _____ QTY @ $29.95 each Total_________

Digital Cover..............................._____ Qty @ $9.95 each Total_________

AstroLapLight............................._____ Qty @ $14.95 each Total_________

Custom Cables ............12 ft. Length _____qty @ $20.00 each total _______

Custom Cables
............25 ft Length ______qty @ $30.00 each total _______

Describe cable PC to _____________________

S/H $3.00 and PayPal Fee $1.55 (prepaid no Paypal Fee) .... ......$4.55 total
International postage ..................................................+$3.00
....................................................................Order Total___________