Ship to Name:

Street Address:

City:

State:

Zip:

Phone Number (order purposes only):

E-mail address: (news letter)

Please check one Visa [] or Matercard []

Name as it appears on the card:

Card Number:

Expiration Date:

V code (last 3 digits on the back of the card)

Billing address if different from the ship to address.

Bill to Name:

Street Address:

City:

State:

Zip:

Pellet size

Weight

Price Each

Qty ordered

Total per line

1/16 mini

3 oz.

$6.85

1/16 mini

8 oz.

$15.75

1/16 mini

16 oz

$27.85

< 1/8"

3 oz.

$5.85

<1/8"

8 oz.

$14.00

<1/8"

16 oz.

$24.95

1/8"

3 oz.

$5.85

1/8"

8 oz.

$14.00

1/8"

16 oz.

$24.95

1/4"

2.75 oz.

$5.85

1/4"

8 oz.

$14.00

1/4"

16 oz.

$24.95

Subtotal

Michigan residents add 6% sales tax

Total *including shipping*