Order Form

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AFTER YOU COMPLETE THIS FORM CLICK SUBMIT BUTTON AND THE ORDER WILL BE SENT TO HEIKE  ACKNOWLEDGEMENT WILL BE SENT BY EMAIL.  ORDER WILL NOT BE SHIPPED  UNTIL  PAYMENT IS RECEIVED.

TITLE
PRICE
SHIPPING/HANDLING
TOTAL INCLUDING SHIPPING/HANDLING
YOUR NAME
YOUR ADDRESS
YOUR CITY/STATE/ZIP CODE
YOUR PHONE NUMBER
YOUR EMAIL ADDRESS