ORDER FORM -- Cruiser’s CrutchTM


~ WE ACCEPT MAIL ORDERS ONLY ~
        Right Click on form to print it, complete form and MAIL TO:

SEC, Inc. - Cruiser's Crutch
20 Stutz Bearcat Drive, #6
Sedona, AZ 86336

Click HERE to return to Cruisers's Crutch Page

ORDERING INFORMATION

Name:

Company:

Title:

Address:

  

City:

  

State:

Country:

Zip/Country Code:

Phone (only in case of problems):

Email (optional): 

Available in English or Metric models:

English (E) BAF's: 10, 20, 30 & 40
   1 -  9...                       $32.29/ea
10 - 19...                      $25.83/ea
20 - 49...                     $19.37/ea
50 +...                   $17.33/ea		 Metric (M) BAF's 2, 3, 4, 5, & 6
   1 -  9...                       $32.29/ea
10 - 19...                      $25.83/ea
20 - 49...                     $19.37/ea
50 +...                   $17.33/ea
(E)/(M) Quantity Unit Price (see above) Amount
English (E)

x

             =

  
Metric (M)

x

        =

  
 

x

=

  
Arizona Sales Tax (x%):     
Shipping & Handling Charges (0 for Orders Over $50.00):    $3.55
Priority Overnight - (Add $16.00):     
TOTAL:     

  Cashier's Check or Money Orders Only -- Please do not send cash
Allow 5-10 working days for normal delivery.
Payable to "SEC-Cruiser's Crutch"