Use the print button on your web browser to print this form.  
If you cannot print the form, you can send us a handwritten or typed order with all the necessary info.

Credit Card Type__________  Nunber______________________   Exp Date_________ Security Code_______

Please make sure checks and money orders are made out to Dave Juliano and/or Michelle Juliano

Please mail your order to:

3570  Belgrade St
Philadelphia, PA 19134

Shipping costs:

Inside USA
.01 - $4.00 add 3.00
$4.01 - $39.99 add $6.50
$40.00 - $99.99 add $10.00
$100.00 - $199.99 add $12.00
$200.00 or more add $14.00 

Outside USA - Please double shipping listed above.