PRINTABLE ORDER FORM

ORDERED BY:

SHIP TO:

Name	_____________________________
Address	_____________________________
	_____________________________
	_____________________________
	_____________________________
Phone	_____________________________
email	_____________________________

Name	_____________________________
Address	_____________________________
	_____________________________
	_____________________________
	_____________________________
Phone	_____________________________
email	_____________________________

ITEM	QUAN.	DESCRIPTION	PRICE EA.	TOTAL
1	_____	____________________________________________	________	________
2	_____	____________________________________________	________	________
3	_____	____________________________________________	________	________
4	_____	____________________________________________	________	________
			sub total	________
			RI sales tax	________
			packaging	________
			shipping	________
			TOTAL	________
			amount enclosed	________
			balance due	________

Please make checks payable to:
Ron Rantilla Rowing Systems
30 Cutler Street #207
Warren, RI 02885