P.O. Box 272882 Fort Collins,CO 80610

Printable Order Form

All orders will be shipped by USPS Priority mail in USA.

SHIP TO:

Name:        _______________________

Co. Name: _______________________

Address:    _______________________

Address:    _______________________

City:___________________ State:___________

Zip:_____________ Country:_______________

PAYMENT METHOD:

Check#:_______   Money Order: $___________

Phone:  (____) -______-________

Email Address; _____________________

Please supply the following items

Product#

PRODUCT DESCRIPTION

QTY

TOTAL AMOUNT

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.

.

$

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.

.

$

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.

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$

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.

.

$

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.

.

$

.

.

.

$

Shipping Rates:  $5.95

Shipping

$

Total

$

Please mail completed form to:

Gotko Product Development

P.O. Box 272882

Fort Collins,CO 80610