Miles Stair's Wick Shop - www.MilesStair.com
 For Mail Orders Only, please fill out this form on your computer, print and mail with a
Money Order or Cashier's Check. Personal checks must clear bank before shipping.
Short form.  For other items or overseas orders, please use the long order form.

WICK #

FOR HEATER MODEL

PRICE @

NUMBER ORDERED

TOTAL US$
$

$
$ $
Igniter # See list for exact igniter PRICE EACH # IGNITERS

PRICE   US $
1  Aladdin, Toyotomi, KeroSun, Corona $ 8.95

$
3  DuraHeat, Robeson, Heat Mate, DynaGlo $ 7.95 $
ACCESSORIES  
      $

Subtotal for merchandise - US Dollars    

 $

          US ONLY      By Amount of Order  - Shipped First Class  

  
US POSTAGE RATES:   -0.01 - $10.00 = $6.95; 10.01 - 26.00 = $7.95; 26.01 - 39.00 = $9.95; 39.01 - 58.00 = 12.95; $59.01 and up = $14.95

 (EXCEPT chimneys -  see limits per chimney / order ).  Overseas Postage, go here.)

 $   $
Priority Mail upgrade for orders under $58.00 (US ZIP Codes ONLY) = ADD $6.00 TO ABOVE for Priority $ 6.00 $

International Order: Use long form.

TOTAL US $ ONLY 

 $
 Your Name
 Your address
 City, State and ZIP Code
 E-mail address

 I will send a Shipping Notice with  Delivery Confirmation number to US destinations with an e-mail address.

Have a question? Please email me at  miles@milesstair.com

 Next day shipping with Cashier's Checks or Money Orders. 
 Please DO NOT send cash or personal checks denominated in non-US funds through the mail! - MAKE PAYABLE TO  MILES STAIR

Send to:   Miles Stair
           PO Box 503
           Coquille, OR USA   97423