Marine Antique Order Form

Please fill in the following blanks and include the item number that you are interested in purchasing

Item Number

First Name:

Last Name:

Street:

City:

State: Zip:

Phone Number:

E-Mail Address:

We are happy to accept Mastercard and Visa.

Card holders name:

Card #: --- Exp. Date:

We will bill you for the total amount plus 7 to 10% (depending on destination) for shipping and handling*.

If you have any additional questions or comments, please let us know in the box. When everything is complete, submit it! Thanks and enjoy!

* The 7-10% is for all items shipped within the continental United States. Mass residents must also pay 5% tax.