ORDER FORM
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Amos Smith
$35
Wells(front) $35
Wells(side)
$35
Galloway
$35
Skinner
$35
Locomotive $95
Whizzer $95
Morris Minor
$95
Mini Cooper $45
NAME
ADDRESS
CITY
STATE
ZIP
E-MAIL
PHONE
CREDIT CARD
CREDIT CARD #
EXPIRATION DATE
PURCHASE AMOUNT
SHIPPING (see note)
TAXES (see note)
TOTAL AMOUNT
Shipping: free in the USA. If ship outside the USA please add 15% to the purchase amount.
Taxes: Michigan residents please add 6% to the purchase amount.
Order through the mail: fill the form and print it, and send it with a check to: Remy Champt - 614 Hastings Street - Traverse City, MI 49686 - USA (write the check to Remy Champt)
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