Please print* and send the order form with your payment: * Use Courier font (or other mono-spaced font) when printing! ====================================================================== LV2000 Order Form ---------------------------------------------------------------------- DATE: ---------------------------------------------------------------------- Send check or money order to: Jeff Hendrix 14163 Jared Ct. Broomfield, CO 80023 ---------------------------------------------------------------------- Ship to: __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ ---------------------------------------------------------------------- Your email address: ---------------------------------------------------------------------- QUANTITY DESCRIPTION PRICE EACH TOTAL -------- ------------------ -------------- --------- [ ] Assembled Kit $ 35.00 (3/$100) _________ Sub-Total: _________ Shipping: 3.00 TOTAL: ========== ======================================================================