MCW Automotive Finishes, P.O. Box 0518, Burlington, NC 27216-0518

Please Print this form and Mail or fax (336-228-0240)

Revised 8/11 Date:
ORDER PAINT ITEMS ON THIS FORM

Note: Minimum order is $10.00
    Check, Money Order, MC or Visa only.
    Orders are filled in 2 or 3 days.
    Allow 1-2 weeks for delivery.
   No Phone, COD, or Pay Pal Orders.

Name:_______________________________________________

Address:_____________________________________________
                           
City:______________________________State:______________

Zip:______________________Phone:_____________________
       

 Qty  Size  Part No  Description               Price ea  Total    Qty  Size  Part No  Description             Price ea  Total  
 

NO RESIN

          

 NO RESIN

    
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
                       
                     
                   Merchandise Total  $_____  _____

Total Merchandise/Shipping & Handling (no Foreign)

U.S. Mail Parcel Post only:  
Orders up to $ 25.00  -  $ 9.00     
    $25.01 to 50.00 - $10.50           $75.01 to 100.00 - $13.50 
    $50.01 to 75.00 - $12.00          $100.00 Up - $15.00

      Thank you for your order!

 Shipping & Handling $_______________________
  (see chart at left)               (NC include in sales tax)
Subtotal  $__________________________

7.75% Sales Tax  $________  __________________ 
  (NC residents only)                    (NC county)
Total Enclosed  $______________________________
                            No phone orders.
  Charge to : [ ] Mastercard [ ] Visa Card # __________________________________________ Exp. date __________

   Signature _________________________________________________ Daytime phone _______________________

   Your billing address_________________________________ City ___________________ State ____ Zip _______
                    
                                  (Sorry, NO orders outside United States - paint is hazzardous material)     

 

 

 

 

 

 

 

Thanks to all modelers for your support!

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