TIDELINES  PRINT / SAVE / FAX / MAIL ORDER FORM 

ITEM  			QUANTITY    	AREA      PRICE EA   	TOTAL

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			       ORDER SUBTOTAL $ ____________

	(SEE ORDERING INFO PAGE FOR SHIPPING RATE CHART)                   

              International Ordering:  Surface: ____  Air: ____ 
         
                 
                            Shipping/Handling $ ____________
             
                           TOTAL ORDER AMOUNT $ ____________ 
         
                            
MAIL OR FAX THIS COMPLETED FORM TO:
                                                                      
TIDELINES                                    
Post Office Box 230431                   ___ Check or Money Order
Encinitas, CA  92024-0431
800-345-8524                             ___ Visa   ___ M/C   ___ Discover
FAX:760-753-6410
EMAIL:surf@tidelines.com                 ________ Exp Date
                                           
ORDERED BY: _______________________   SIGNATURE: ______________________

CARD NUMBER: _____________________________   PHONE#: __________________

ISSUING BANK: _________________   NAME ON CARD: _______________________


SHIP TO:                              BILL TO:
Name: _____________________________   Name: ___________________________

Company: __________________________   Company: ________________________

Address: __________________________   Address: ________________________

City: _____________________________   City: ___________________________

State: ______   Zip: ______________   State: ______   Zip: ____________

Day Phone: ________________________   Day Phone: ______________________
                    
        100% Satisfaction Guaranteed ! ! !    7 - 10 days for delivery
            THANK YOU FOR YOUR ORDER and VISITING OUR WEB SITE