HIGH SIERRA MFG. CO. 6247 Hwy. 140 Midpines, Calif. 95345-9702 http://mariposa.yosemite.net/hsmc/ Die Casting Phone: 209-966-2780 Precision Machining Fax: 209-966-2780 Photographic Equipment E-mail: hsmc@yosemite.net ORDER FORM: for USA -------------------------------------------------------------------------- ORDERED BY: SHIP TO (if different): Name:_______________________________ Name:_______________________________ Address:____________________________ Address:____________________________ City:_______________________________ City:_______________________________ State:__________ Zip:_______________ State:__________ Zip:_______________ E-mail address:_______________________________________ Date:______________ -------------------------------------------------------------------------- QUAN | DESCRIPTION | PRICE | TOTAL | -------------------------------------------------------------------------- | CLAMPETTE camera clamp-mount (bulk) | | | | (includes U.S. First-Class postage) |$13.50ea | . | -------------------------------------------------------------------------- | CLAMPETTE in hinged-lid, clear plastic box | | | | (includes U.S. First-Class postage) |$13.75ea | . | -------------------------------------------------------------------------- | Carton of 1 dozen CLAMPETTEs (bulk) | | | | (includes U.S. Parcel Post) |$112.00 | . | -------------------------------------------------------------------------- | Carton of 1 dozen CLAMPETTEs in plastic boxes | | | | (includes U.S. Parcel Post) |$115.00 | . | -------------------------------------------------------------------------- | CLAMPETTE w/neoprene on head (bulk) | | | | (includes U.S. First-Class postage) |$13.75ea | . | -------------------------------------------------------------------------- | CLAMPETTE in hinged-lid, clear plastic box | | | | (includes U.S. First-Class postage) |$14.00ea | . | -------------------------------------------------------------------------- | 1 dozen CLAMPETTEs w/neoprene on head (bulk) | | | | (includes U.S. Parcel Post) |$116.00 | . | -------------------------------------------------------------------------- | 1 dozen CLAMPETTEs w/neoprene in plastic boxes | | | | (includes U.S. Parcel Post) |$120.00 | . | -------------------------------------------------------------------------- | CLAMPETTE Bike-Handle Mount (bulk) | | | | (includes U.S. First-Class postage) |$15.75ea | . | -------------------------------------------------------------------------- | CLAMPETTE Bike-Handle Mount in plastic box | | | | (includes U.S. First-Class postage) |$16.00ea | . | -------------------------------------------------------------------------- | 1 dozen CLAMPETTE Bike-Handle Mount (bulk) | | | | (includes U.S. First-Class postage) |$142.00 | . | -------------------------------------------------------------------------- | 1 dozen CLAMPETTE Bike-Handle Mount in p/b | | | | (includes U.S. First-Class postage) |$145.00 | . | -------------------------------------------------------------------------- | CLAMPETTE M4 Right-angle Head | | | | (includes U.S. First-Class postage) |$ 5.00ea | . | -------------------------------------------------------------------------- SUBTOTAL | . | --------------------------- (Calif. residents add 7.75% sales tax) Sales tax | . | --------------------------- Special & foreign shipments: please contact us Spe. Shipping | . | --------------------------- Credit Card payment may be made through TOTAL ENCLOSED | . | http://www.PayPal.com --------------------------- Thank you for your order.