MILES' TO GO                              DATE:________
P.O. BOX 6                                SHIPPING PREFERENCE
CORTARO, AZ 85652                         ____PRIORITY MAIL - SEE CHART BELOW
PHONE 520-682-7272, FAX 520-682-0480      ____EXPRESS MAIL - CONTACT US FOR COST
E-mail Miles2G@aol.com                    ____POSTAL CARRIER RELEASE
ORDERED BY:

Name ______________________________________________________Phone__________________

Address___________________________________________________________________________

City __________________________________ State ______________________ Zip__________

Visa, M/C, AMEX No.____________________________________________V-Code_______

Exp. Date________Signature___________________________Email________________________

SHIP TO:(If different than above.)
Name _________________________________________________________Phone_______________
Address___________________________________________________________________________
City __________________________________ State ______________________ Zip__________

|Quantity|__Cat#_|______________________Name_________________|Unit Price|__Amount_|
|        |       |                                           |          |         |
|________|_______|___________________________________________|__________|_________|
|        |       |                                           |          |         |
|________|_______|___________________________________________|__________|_________|
|        |       |                                           |          |         |
|________|_______|___________________________________________|__________|_________|
|        |       |                                           |          |         |
|________|_______|___________________________________________|__________|_________|
|        |       |                                           |          |         |
|________|_______|___________________________________________|__________|_________|
|        |       |                                           |          |         |
|________|_______|___________________________________________|__________|_________|
|        |       |                                           |          |         |
|________|_______|___________________________________________|__________|_________|
|        |       |                                           |          |         |
|________|_______|___________________________________________|__________|_________|
|        |       |                                           |          |         |
|________|_______|___________________________________________|__________|_________|
|        |       |                                           |          |         |
|________|_______|___________________________________________|__________|_________|
SHIPPING: PRIORITY MAIL UNDER $25 - ADD $10.00                          |         |
          PRIORITY MAIL BETWEEN $25 AND $50 - ADD $5.00        SUBTOTAL |_________|A
          PRIORITY MAIL OVER $50 - FREE SHIPPING                        |         |
          EXPRESS MAIL - CONTACT US FOR SHIPPING CHARGES       SHIPPING |_________|B
                                                                        |         |
                  STATE SALES TAX (ARIZONA ORDERS ONLY) 7.1% x SUBTOTAL |_________|C
                                                                        |         |
                                                   LESS PREVIOUS CREDIT |_________|D
                                                                        |         | 
                                                            ORDER TOTAL |_________|
                                                              (A+B+C-D)                   
                           SUBSTITUTES    
 __CAT#________________________NAME________________________PRICE_        
|________|_____________________________________________|_________|
|________|_____________________________________________|_________|
|________|_____________________________________________|_________|
|________|_____________________________________________|_________|
|________|_____________________________________________|_________|