------------------------------------------------------------------ KwikDraw Order Form The Human Interface 902 94th St. S.E. Everett, WA 98208 (206) 348-9043 ------------------------------------------------------------------ Name: _________________________________________________________ Address: _________________________________________________________ _________________________________________________________ City: ________________________ State: _______ Zip: ____________ Country: __________________________ Phone: _______________________ Qty: ______ x $29.95 = $____________ Shipping Rates Shipping (see rates) = $____________ U.S. & Canada: Qty 1-3: $3.00 Qty 4-6: $5.00 Qty 7-10: $7.00 C.O.D. fee ($3.00) = $____________ overseas: Total = $____________ Qty 1-3: $4.00 Qty 4-6: $7.00 Qty 7-10: $10.00 please check one: ____ Please ship C.O.D. (U.S. only, $3.00 additional charge) ____ Check enclosed (if you are not from the U.S. or Canada then please use a check drafted on a U.S. bank or an international money order in U.S. funds, which you should be able to obtain at your local post office) please allow 2 weeks for delivery