Shipping Address
| Name: | ____________________ |
*Phone: | ____________________ |
| Address: | ____________________ |
*Email: | ____________________ |
| City: | ____________________ | | |
| State: | ____________________ | | |
| Zip: | ____________________ | | |
*We need this information in case we have questions regarding your order.
| Quantity
|
Price / ea. |
Shipping & Handling fee |
Total Price |
| Steal-Proof Master Video |
|
$25.00 |
$5.95 ea |
|
| Refuse to Be A Victim Booklet |
|
$5.00 |
$2.00 ea |
|
| Door Lock |
|
$20.00 |
$3.95 ea |
|
| "The Executive" Door Lock |
|
$49.95 |
$3.95 ea |
|
| Pepper Home and Auto |
|
$20..00 |
$3.95 ea |
|
| Pepper Key Ring |
|
$15.00 |
$3.95 ea |
|
| Guardian Nylon Backpack* |
|
$49.99 |
$7.95 ea |
|
| Guardian Laptop Backpack* |
|
$65.00 |
$7.95 ea |
|
| Guardian Leather Backpack* |
|
$150.. |
$7.95 ea |
|
| Sliding Glass Door Pin |
|
$5.00 |
$1.00 ea |
|
| "Call Police" Car Signs (Qty 2) |
|
$5.00 |
$1.00 ea |
|
| Personal Safety Video |
|
$25.00 |
$5.95 ea |
|
| Order Subtotal |
|
| Order Total |
|
*Please note color(s) next to your shipping & handling fee when ordering backpacks.
If you would like to use your credit card by mail, rather than on-line, please complete the table below.
| Name as it appears on credit card |
_________________________________ |
| Credit Card type (Visa or Mastercard) |
_________________________________ |
| Credit Card Number |
_________________________________ |
| Expiration Date |
_________________________________ |
Shipping takes approximately 5 days after an order is received, within the U.S.
If you send a personal check, please allow 2 weeks for your check to clear.
Send this completed form and check or money order to:
Donna Kirby-Reynolds
5 Saundra Drive
Westerly RI 02891
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