Jackson Enterprises, Inc.
ORDER FORM FOR CHECKS AND MONEY ORDERS
If you pay with a personal check your order will not be shipped until your check clears. This usually takes up to 10 days.

This form can be filled out on your computer and printed for mailing.
• Indicate the name of the item, the price and quantity you wish to purchase.
• Use the shipping rate chart to determine your shipping charges and add to the total of your purchases.
• Indicate the total amount below.
Name of Item
Price Qty.

Shipping and handling charges will be calculated by the dollar amount of the order. Regular shipping will be either
USPS or UPS

Under $25 $5.95
$25.01 - $50 $7.95
$50.01 - $75 $9.95
$75.01 - $125 $12.95
$125.01 and up $15.95

Purchase $ _________

Shipping $ ________

Total $ __________

Mail to:
Jackson Enterprises, Inc.
4908 Washington Blvd.
Arlington, VA 22205-2545

Fax to:
703-524-4998