Lakeview Co., Order by Mail

3620-9A Whitehall Road
Anderson, SC 29626
Phone (864)226-6990; Fax (864)225-4565

Order by MAIL

This form for use with orders from OUTSIDE the USA

Complete the information below.
Print this form.
MAIL the completed form, including check, money order (U.S. funds only), or credit card information, to
Lakeview Co., Inc.
3620-9A Whitehall Road
Anderson, SC 29626 USA

Fields in RED are required to fill your order

Date:
P O #:
Phone No: Country, City, Local
Call Sign:
E-Mail:	(for confirmation)
Company:
Ship to Name:
Address1:
Address2:
City, Country, Post Code:
Credit Card:	Exp Date: Mon, Yr: Required unless cheque or money order in U. S. funds is enlosed.

Item	Quantity	Catalog No.	Item	Quantity	Catalog No.
1			2
3			4
5			6
7			8
9			10
11			12

Enter any special note or request:

Order Subtotal $
Shipping and Handling (We will provide a firm S&H cost upon email request, including each item you wish to buy.) $
Grand Total $

Please enclose cheque or money order in U. S. funds (only) for the Grand Total, or complete the credit card information. Your order will be shipped as soon as possible.

Order Subtotal	$
Shipping and Handling (We will provide a firm S&H cost upon email request, including each item you wish to buy.)	$
Grand Total	$