PEC: PE Central Challenge Pin Purchase Order Form

PE Central Challenge
Pin Purchase Order Form
Make Checks Paybable to PE Technologies

Ship to (your name): ____________________________________ Date: ___________

School/Organization Name: _______________________________________________

Street: _______________________________________________________________

City: _______________________________ State: ___________ Zip: _____________

Phone: ________________ Fax: ________________ E-mail: ____________________

ITEM

QUANTITY

ITEM COST

TOTAL

Gold Pins
X $1.25
=

Silver Pins
X $1.25
=

Bronze Pins
X $1.25
=

Sub Total:
=

USA Shipping Cost
$5.50 on orders 0-$50
$7 on orders $50.01-100
$8.50 on orders $100.01+
Int'l Shipping
Add $16.75 on orders 0-$50
$18.25 on orders $50.01-100
$19.75 on orders $100.01+
=

Virginia Residents Only
Add 5% Sales Tax
(Total X .05)
=

TOTAL:
=

Make Checks and Purchase Orders payable to: PE Technologies
(Mail to: PE Central, PO Box 10262, Blacksburg, VA 24062; Fax: 540-301-0112)

ITEM	QUANTITY	ITEM COST	TOTAL
Gold Pins		X $1.25	=
Silver Pins		X $1.25	=
Bronze Pins		X $1.25	=
		Sub Total:	=
		USA Shipping Cost $5.50 on orders 0-$50 $7 on orders $50.01-100 $8.50 on orders $100.01+ Int'l Shipping Add $16.75 on orders 0-$50 $18.25 on orders $50.01-100 $19.75 on orders $100.01+	=
		Virginia Residents Only Add 5% Sales Tax (Total X .05)	=
		TOTAL:	=