Mail Order Form
Please fill in the
following information for your order. Note that all personal
information, including email address is required! At the end of the
form you will find a short statement to sign concerning your being
legally able to order and receive these products. NO ORDERS WILL BE
SENT WITHOUT THIS BEING SIGNED!! NAME , SHIPPING ADDRESS, STREET ADDRESS ONLY, NO PO
BOXES! , CITY, STATE, ZIP , EMAIL ADDRESS ,
Your Order MAY be mixed, powder, granulation(s), Pre-Measured
Loads™ AND/OR STICKS™ - Just make a notation as to the
mixture you would like
NUMBER OF FULL CASES 2F, 12 per case,
$199.90 PER CASE CASE(S) , NUMBER OF FULL CASES 3F, 12 per case.
$199.90 PER CASE CASE(S) , NUMBER OF MIXED CASES 2F/3F, 12 per
case, $199.90 PER CASE - HOW MANY OF EACH? CASE(S) , NUMBER OF FULL CASES 50 Grn 45 Caliber
STICKS™, 12 per case, $233.00 PER CASE CASE(S) , NUMBER OF FULL CASES 50 Grn 50 Caliber
STICKS™, 12 per case, $233.00 PER CASE CASE(S) , NUMBER OF FULL CASES 100 grain
Pre-Measured Loads™, 12 per case, $181.80 PER
CASE CASE(S) , NUMBER OF FULL CASES 150 grain
Pre-Measured Loads™, 12 per case, $181.80 PER
CASE CASE(S) , FULL MIXED CASE ORDER 2F/3F 17.00,
STICKS™ 19.95, Pre-Measured Loads™ 15.59 ea,
MIXTURE , PARTIAL CASE ORDER 2F/3F 17.50,
STICKS™ 19.95, Pre-Measured Loads™ 15.59 ea, PLUS
SHIPPING MIXTURE , NUMBER OF FULL CASES JIM SHOCKEYS
GOLD™ 2F, 12 per case, $217.90 PER CASE CASE(S) , NUMBER OF FULL CASES JIM SHOCKEYS
GOLD™ 3F, 12 per case, $217.90 PER CASE CASE(S) , NUMBER OF FULL CASES JIM SHOCKEYS
GOLD™ MIXED 2F/3F, 12 per case, $217.90 PER
CASE CASE(S) , NUMBER OF FULL CASES JIM SHOCKEYS
GOLD™ STICKS™, 12 per case, $242.90 PER
CASE CASE(S) , , , ,
REQUIRED STATEMENT
I, by my signing this statement, certify that there are no local, state or federal laws or regulations that would either prohibit my purchase and delivery or that would require additional actions to conform to regarding my order and delivery of American Pioneer powder or STICKS compressed charges and that I am at least 18 years of age and legally responsible for my actions. This includes any zoning or fire department regulations concerning the storage and possession of these products. I also certify that I will only use these products in a safe and legal manner, and hold any and all parties involved in the manufacture, shipment or sale of these products harmless and free from liability for any of my actions, either intentional or accidental, during the use or storage of these products. I am familiar with the safe use of these products and the firearms that they are intended to be used in, and I will use these products in a safe and legal manner at all times. I understand that firearms and the ammunition and/or components are, by their very nature dangerous and that the use or possession of either or both may result in death or injury to those around, whether or not they are personally using the products. I also understand that these products are not warranted for any particular use or application.
______________________________________________________
Mail completed form and payment to:
Glen R. Parshall, TheSpiritOf76.com, 4605 E. Monroe Ave, Las Vegas, Nevada 89110
Make payable to Glen R. Parshall