Product	Price	Quantity Ordered	Total Amount
Channel Tech Workroom Kit	$129.99 each kit
Georgia residents add 7% sales tax :
Channel Tech S&H ($25.99 for each kit shipped to same address in the continental United States):
Total for Channel Tech ($155.98 for each kit including S&H):

Billing Information
Visa | Mastercard | Check | Money Order (circle one)
Today's Date
Name as it appears on the credit card
Credit Card Number
Verification Number*
Card Expiration Date
Total $ Amount Charged

Ship To Address (must be same as billing address on credit card statement, if paying by credit card)
Name
Street
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Channel Tech Shipping &Handling :
One Kit	$19.99
Each Additional Kit	$ 9.99 each*

* Kits must be shipped to the same address.