Go Kart Supply Mail In Order Form ... gokartsupply.com

Name: Daytime Phone:
Co Name or Dept: Evening Phone:
Street Address: Email:
City: Comments:
State:
  		Zip Code:
Part Number Product Description Quantity Unit Price Total Price
         
         
         
         
         
         
         
         
Shipping & Handling Charges
For Shipments To The 48 US States Only
If Your
Subtotal Is:

Please Enter
This Amount:
$00.00 to $19.99 $ 7.50
$20.00 to $29.99 $ 8.50
$30.00 to $39.99 $ 9.50
$40.00 to $59.99 $ 10.50
$60.00 to $79.99 $11.50
$80.00 to $99.99 $12.50
$100.00 to $149.99 $14.50
$150.00 to $199.99 $17.50
$200.00 to $249.99 $22.50
$250.00 to $299.99 $26.50
$300.00 to $349.99 $32.50
$350.00 to $399.99 $36.50
$400.00 to $449.99 $40.50
$450.00 to $500.00 $45.50
Order Subtotal  
LA. Residents Only
Add 4% Sales Tax		  
Add Shipping Charges:
Use the table to the left		  
ORDER TOTAL  
Mail In Orders To:

Go Kart Supply Online Catalog
12784 Mansfield Road
Keithville, Louisiana 71047

gokarts@gokartsupply.com
318-925-2224
Form of Payment:    ____ Money Order     ____ Bank Issued Cashier's Check    
We Do Not Accept Personal Checks or Business Checks

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