If you are located outside the United States, please
e-mail or call us (at
812-332-1478) for shipping costs.
If you are located in the USA, you can print the form
below, fill it
out, and mail or fax it to us.
Name: ________________________________________________
Address: ________________________________________________
________________________________________________
City: __________________ State: _____ ZIP: ___________
Daytime phone number (in case we have
a problem with your order): ______________________________
Method of payment (check one):
[ ] Check [ ] VISA [ ] MasterCard
[ ] American Express [ ] Corporate PO # ________________
Credit Card #: __________________________________________
Exp. date: ________ Signature: ________________________
ITEMS ORDERED:
ORDER CODE PRODUCT NAME PRICE
__________________________________________________________
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TOTAL PRICE | |
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SALES TAX (5% of total price | |
for Indiana residents) | |
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TOTAL SHIPPING | |
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GRAND TOTAL | |
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Fax this form to: 812-332-5701 (24 hours a day, 7 days a week) or mail it to Workshops by Thiagi, Inc.; 4423 E Trailridge Rd; Bloomington, IN 47408-9633