ORDERING INFORMATION:

We need to receive this form or the equivalent by mail.

We only accept payment by CHECK or MONEY ORDER, we cannot accept credit card payment.

At this time we can only ship to addresses within the United States.

 

QTY#B-600 Black/brown with inner holster   $19.95ea 
QTY#SJ-B3 Black vinyl with inner holster   $24.95ea 
QTY#BLYKK Black Leather with inner holster $39.95ea 
                                   Shipping & Handling  $4.00 
                                                               Total 

CUSTOMER / SHIP TO INFORMATION

NAME           
STREET ADDRESS 
CITY/STATE      
ZIP CODE       
DAYTIME PHONE  
E-MAIL ADDRESS 

Lange Company Inc.

3430 Spring Blvd.

Eugene, Oregon 97405

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Home Page / Styles & Pricing / links / Other Products

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mail@langecompany.com

Fax #

( Your comments and ideas are always appreciated )