Item Qty Cost Total

4’ x 10’ Roll $ 29.95 $

4’ x 50’ Roll $ 130.00 $

4’ x 120’ Roll $ 225.00 $

10’ Splice Tape $ 2.50 $

150’ Splice Tape $ 25.00 $

Sub-Total $

H.A.M.B. Alliance Member Discount – 10% $

Shipping ($8.50 per 10’ roll / $30.00 per 50’ roll / $35 per 120’ roll) $

TX residents + 6.75% (Including Shipping) $ (TX Only)

Grand Total $

I have enclosed a check or money order. Please ship my order to:

Name: Street:

City, State, Zip: Please check if this is a business address

Phone: Email:

Please charge my credit or debit card (must match card billing info): Can be faxed to 806-842-5301

Name: Street:

City, State, Zip: Type of Card:

Card Number: Expiration Date:

CVV Code: (3 digits on back of Visa or M/C, 4 digits on front of AmEx) Phone:

Shipping Address (if different from billing): Please check if this is a business address

Name: Street:

City, State, Zip: Phone: