Order Form

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	We can now accept credit card orders through PayPal.com! Feel secure .. CLICK HERE to use your credit card to order BACK MATE.

If you prefer to send a check or money order, please fill out this order form. Then print out a copy of your completed order form and then send it along with a check or money order to address at bottom of screen. Wisconsin residents add 5% sales tax. If you are a merchandiser interested in reselling BACK MATE through your place of business, or if you just need more information, please fill out this form and then hit the send button at the bottom of the form.

Your Name___________ Organization________ Address 1___________ Address 2___________ City________________ State_______________ ZIP Country_____________ Telephone number____ Email address_______ Choose one of the following: I would like more information about BACK MATE I am ordering BACK MATE

If ordering state quantity of BACK MATES you would like:
Quantity multiplied times $11.95 per BACK MATE equals SUBTOTAL:
Wisconsin residents add 5% sales tax
Domestic Orders & International Orders: add $3.00 Shipping and Handling for single BACK MATE. If ordering more than one, add $1.00 shipping and handling for each additional BACK MATE ordered.

GRAND TOTAL: (U.S. Funds Only)

Please include any comments or specific questions you would like addressed. If ordering, you may specify colors for the BACK MATEs you have ordered in next section.	CHOICE OF COLORS White ---- Lavendar Grey ---- Bone LIMITED QUANTITIES

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Send your completed Order Form along with Check or Money Order to:

A.W. Enterprises, Inc.
P.O. Box 852
Menomonie, WI 54751

Allow 2 weeks for delivery
Call (715) 235-0567 if you have questions or would like to order by phone

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	A.W. Enterprises, Inc. P.O. Box 852 Menomonie, WI 54751 Contact Us At: aweinc@charter.net Call (715) 235-0567
Copyright © 1999 - 2009 A.W. Enterprises, Inc. - All Rights Reserved BACK MATE® is a registered trademark of A.W. Enterprises, Inc.

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