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Pacific Warriors, Inc.
PO Box 1410
Boulder Creek, CA 95006
Info: 408-338-0256
Customer Billing Address
Name:_____________________________________________________
Address:__________________________________________________
City:____________________________ State:____ Zip:_________
Tel: Home: _______________________________________________
Tel: Work: _______________________________________________
Email:____________________________________________________
Ship to Address (if different)
Name:_____________________________________________________
Address:__________________________________________________
City:____________________________ State:____ Zip:_________
Tel: Home: _______________________________________________
Tel: Work: _______________________________________________
Email:____________________________________________________
Method of Payment (Check one)
[ ] Check [ ] Money Order (Sorry no C.O.D.'s or cash)
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| Qty | Description | Price | Total |
+-----+-----------------------------------+-------+-------+
| | The Disfavored Hero (Collectable) | $49.95| |
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| | The Disfavored Hero (Paperback) | $16.00| |
+-----+-----------------------------------+-------+-------+
Total price of items | |
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CA residents add 8.00% sales tax | |
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Shipping & Handling | |
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Grand Total | |
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Shipping & Handling Charges
Shipping
Payment
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www.pacificwarriors.com