Burke Racing
Order Form

Return to Home PageProduct On-Line CatalogPlace your OrderContact Burke RacingExpand Your Advertising with Burke Racing

Burke Racing Order Form

Sold to:

Adress:

City: State: Zip Code:

Phone: Fax:

email address:

Payment Method:

Card Holder Name:

Card Number: Expiration Date:

 

Item #1
Description: Unit Price: Qty: Total Cost:

Item #2
Description: Unit Price: Qty: Total Cost:

Item #3
Description: Unit Price: Qty: Total Cost:

Item #4
Description: Unit Price: Qty: Total Cost:

Item #5
Description: Unit Price: Qty: Total Cost:

Item #6
Description: Unit Price: Qty: Total Cost:

Item #7
Description: Unit Price: Qty: Total Cost:

Item #8
Description: Unit Price: Qty: Total Cost:

Item #9
Description: Unit Price: Qty: Total Cost:

----------------------------------------------------------------------------------Subtotal:

----------------------------------------------------------------6% Tax (Oh Residents):

--------------------------------------------------------------Shipping(see table below):

-----------------------------------------------------------------------------Order Total:

------------------------ Shipping Zone (see Map Below)--------------------------

Subtotal
Amount

1

2

3

4

5

Alaska

Hawaii

$1-20

$6.75

$5.95

$7.00

$7.35

$8.25

$22.50

35.75

$21-50

$7.50

$6.95

$8.10

$8.50

$10.75

$32.00

$45.25

$51-100

$9.50

$9.00

10.75

$13.25

$18.00

$50.35

$63.50

$101-200

$12.25

$11.25

$14.25

$18.25

$25.50

$67.50

$80.50

$201-500

$15.00

$13.50

$17.95

$22.95

$32.50

$83.75

$97.00

$500+

FREE

$102.00

$115.00


Mail to:
Burke Racing
7544 Hunters Trail
Hamilton OH 45011

--or--
Fax to:
513-942-01888