Mach 1 Scuff Plate Order Form
 (Just print out, Fill in and mail with payment)

Make Checks/Money Orders Payable to and send to:
 

Mailing Address:
Jay Jordan
1401 Bagby #11
Waco, TX 76706
email: Jay_Jordan@baylor.edu 
 

 QTY

Each

TOTAL

Mach 1 Scuff Plates

SELECT FINISH:

____ POLISHED   ____ SATIN/BRUSHED

 

$79.95
Alaska & Hawaii Please add $10.00 S/H
TOTAL:
 

Type of Payment:  ( ) Check  ( ) Money Order

NOTE: CANADIAN Checks or Money Orders,
please add $5.00 International Bank cashing fee. 
( ) Canada Check   ( ) Canada Money Order

Mailing Form (Where to send the stuff!)

Your Name: ________________________

Mailing Address: _____________________

City: ___________________  State: _____________  Zip:__________

email: (for verification and notification): ___________________________