Cloud K9 ® Order Form

CALL: MAIL:
1-314-842-7521     Cloud K9®        MASTERCARD and VISA Accepted
... Order Dept., PO Box 22461       Checks & Money Orders in US FUNDS
... St. Louis, MO 63126 USA       Sales to USA Only

1) Print Out Order Form     2) Fill It Out     3) MAIL to Address / or CALL Phone Number Above

___Check     ___Money Order     ___Mastercard     ___Visa

Credit Card #_____________________________ Exp. Date________

Signature (for Credit Card Orders)_____________________________

Name__________________________________________________

Address________________________________________________

City______________________ State_____________ ZIP_________

Daytime Phone # (required)__________________________________
Item Description Quantity Price Total
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*U.S. Shipping Rates* *Subtotal* ____________
Order:                    Add: Missouri residents add 6.075% Sales Tax ____________
Up to $14.99           $4.95 Shipping rates based on *Subtotal* (not including sales tax) (rates shown on the left) ____________
$15.00 - $29.99       $6.95 TOTAL ____________
$30.00 - $49.99       $8.95
$50.00 - $74.99       $10.95
$75.00 or more       $12.95

      Note: Checks are held for at least 10 Business Days before orders are sent.
      Prices subject to change without notice.
Home website: www.cloudk9.com