Elements Cafe 3 Order Form

Use your credit card or send a check or money order for $129  Radio Mall, 2412 Unity Ave. N., Dept. EAR3W, Minneapolis, MN, 55422, USA.  MN residents, please add sales tax. Foreign orders, please add $20 for shipping. All payments must be in U.S. funds. 

Name_________________________________________ Company ___________________________________

Address__________________________________________________________________________________

City, State, Zip__________________________________________________Country ____________________

Phone________________________ FAX________________________ E-Mail__________________________

How you found us_____________________________________________

____VISA ____ MasterCard ____ American Express/Optima ____Discover 

Card#__________________________________ Exp. Date______Signature___________________________CCID_____

For credit card orders, phone or FAX 763-522-6256

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