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WIZPOUCH order form for Mail in Payment for USA residents

Fill out and print, then mail with your payment. That's it!!

**Please write you email address on the check, it helps!!**

[FrontPage Save Results Component]

Please provide the following shipping information:

            Name 
  Street Address 
 Address (cont.) 
            City 
  State/Province 
 Zip/Postal Code 
          E-mail

Please provide the following ordering information:

  QTY     Color

 7xx series Black  Burgundy           x 9.99 =   $

 590 series Black                       x 9.99 =   $

(Connecticut residents must add 6% sales tax to total)

Thank you for your order!!!!!

Make Money orders or checks payable to Nutmeg Peddlers

Mail this form and payment to:

WIZPOUCH

c/o Nutmeg Peddlers

P.O. Box 7272
Kensington, CT 06037-7272

Your information given on this order form will NOT be sold or disclosed to any other source.