Herm's Slot Shop Order Form - www.vintageslotcars.com ----------------------------------------------------------------------------- You can submit your initial order via our online order form. We will get back with you for confirmation. When sending in your payment, you can use this order form or print out the email we send you. Ordered by / Ship to Name:__________________________________________________ Address 1:_______________________________________________ Address 2:_______________________________________________ City:____________________________________________________ State:__________________________________ Zip Code:_______________________________ Country:________________________________ Phone Number:_____________________________________ Email Address:_____________________________________ If you want the items sent to another address, please fill in the information below: Name:__________________________________________________ Address 1:_______________________________________________ Address 2:_______________________________________________ City:____________________________________________________ State:__________________________________ Zip Code:_______________________________ ------------------------------------------------------------------------------------------------ Item# Item Description Quantity Price Each Total ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ Items Total --------------- Shipping ------------------ Final Total ------------------ If you are looking for something? Have any comments or questions? ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------ Run out of space for ordering items??? Attach a separate piece of paper with the information. Shipping cost is usually anywhere from $4.00 to $5.50 within the USA... Payment is in US Dollars: Money Orders preferred. Personal checks will delay your order as they must clear the bank first. Please specify if you will not accept substitutions!!! Please send your payment / orders to: Herm's Slot Shop 610 SE HWY 14 Billings MO 65610 USA Phone: 417-744-2600 Best to call after 7pm Central Time We accept Checks / Money Orders as payments... Sorry, we do not accept credit cards at this time and DO NOT SEND CASH. Call us at 417-744-2600 or email us at herms_slot_shop@hotmail.com with any questions, etc. Please visit www.vintageslotcars.com for all your vintage slot car needs (C)1999-2007 Herm's Slot Shop www.vintageslotcars.com