Order Form

Item Description:  ______________________________________

Color:  ___________  Size:  ___________  Quantity:  _____  Price:  ________ 

                                                                                                Shipping: ________

Item Description:  ______________________________________

Color:  ___________  Size:  ___________  Quantity:  _____  Price:  ________ 

                                                                                                Shipping: ________

Item Description:  ______________________________________

Color:  ___________  Size:  ___________  Quantity:  _____  Price:  ________ 

                                                                                                Shipping: ________

                                                                                                 Total:  $__________

Louisiana residents add 9% sales tax                                            $__________

                                                                                  Grand Total:    $__________

Ship To:  _________________________________________________

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Special Instructions:  _______________________________________

Name as it appears on card:  _____________________        Date:  ______________________

Credit Card #: _____________________    Type: Visa  MC  Discover

EXP Date: ____________

Make check or money order payable to "KRUZ"