CSF Printable Order Form

CULPEPPER'S SPECIALTY FIREARMS
PO Box 636, Dunbar, WV 25064
(304) 768-7645

Customers desiring to place an order should use this printable form.
Completed order forms should be submitted by mail to the address above.


QTY	SKU	ITEM DESCRIPTION	PRICE	TOTAL
			$	$









		Subtotal :		$
		Shipping Charges :
		Sales Tax (WV Residents add 6%) :
		Total :		$
BILLING & SHIPPING INFORMATION
Name:
Street address:
Street address:
City, State, Zip:
CONTACT INFORMATION - REQUIRED
E-mail address:
Telephone:
CREDIT CARD INFORMATION
Credit Card Type (VISA-MC-DISCOVER):
Name as it appears on Credit Card:
Card Number:
Expiration Date:
Three Digit Security Code On Back:
Signature of Card Holder: