| ____
Check enclosed payable to: Steve Eckels
____
Charge to credit card (Circle one: Visa or Mastercard) Phone orders
accepted, telephone (406) 257-6878.
Credit
card # ________________________________________
Expiration
date (required) ____________________________
Signature
___________________________________________
Name
& Address as it appears on your credit card statement, if different
from shipping address below:
_____________________________________________________
_____________________________________________________
_____________________________________________________
|