Order Blank
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Lewis Hunting Accessories
933 County Road AA
Nekoosa, WI 54457
Your Name(Please Print)____________________________
Daytime Phone (____)_____________
Address_____________________________________
City_______________________________
State_________Zip__________________
Visa or Mastercard
Card #__________________________________
Exp. Date_____/_______/______
Signature__________________________________________
Name and address as they appear on your card
Name__________________________________________
Address_____________________________________
City_______________________________
State_________Zip__________________
| Qty | Item # | Description | Price Each | Total |
| BE | Bright Eyes | $4.00 | ||
| NDBE | Night & Day Pin | $6.50 | ||
| TB | Twice Bright Eyes | $4.50 | ||
| AWS | All Way Shine | $4.50 | ||
| TR | Flagging Ribbon | $3.50 | ||
| GTR | Glo-Flagging Ribbon | $2.35 | ||
| SR | The Strapper | $16.99 | ||
| 108A | Trophy Kit | $27.99 | ||
| Sub Total | ||||
| WI Residents Add 5% Sales Tax |
||||
| Total |
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