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First Name
Last Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
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Home Phone
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QTY	DESCRIPTION	PRICE
	TOTAL

	SHIPPING (If different from above)
Full Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
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NOTE: It is important that ALL of the above information is filled out. We DO ACCEPT CREDIT CARDS but, for your safety DO NOT submit credit card information. The Taft's will contact you once your order is received. At this time, both special shipping requests and payment type will be discussed. We look forward to speaking with you.