CRAZIES ORDER FORM

Use your credit card or send a check or money order for $49 to Radio Mall, 2412 Unity Ave. N., Dept. CRAZW, Minneapolis, MN, 55422, USA. MN residents, please add sales tax. All payments must be in U.S. funds. Foreign orders, please add $13 for shipping.

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 or 800-759-4561

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