PaintCOST Estimator Order Form

First Name: 
Last Name:
Company:
Address1:
Address2:
City:
State:
Zip:

Phone:
Fax:
Email:

Payment:
Amount:				1		$39.00		$39.00
Sales Tax (CA orders):						 $____
S&H:								 $4.50

Total								 $____

Payment By:
__Check
__MO

				
Mail To:
CPR International, Inc.
P.O. Box 6394
Folsom, CA 95763

