Pedal-Sta Order Form

If you prefer not to order online, print this order
form and mail with check or charge information
to our address below. If you can not print the form
and would like one mailed to you,
e-mail us your request at contact@pedal-sta.com
You can also mail requests or questions
to the address below.
Thanks for your interest,
Pedal-Sta Customer Service
 SHIPPING & HANDLING
Up to $10 add: $5.95
Up to $20 add: $6.95
Up to $30 add: $7.95
Up to $40 add: $8.95
Up to $50 add: $9.95
Up to $60 add: $10.95
Up to $70 add: $11.95
Up to $80 add: $12.95
Up to $90 add: $13.95
Up to $100 add: $14.95
Up to $110 add: $15.95
Over $120 add: $16.95
Ship to:
Name________________________________________________________________________

Address______________________________________________________________________

City__________________________________State___________Zip_____________________

Phone__________________________________e-mail:________________________________
Bill to (If different than shipping--must be the same name on credit card):

Name________________________________________________________________________

Address______________________________________________________________________
Item: Price each Quantity Total
Pedal-Sta I $ 7.99 . .
Pedal-Sta II $13.99 . .
Serger Pad $19.99 . .
Support Brace $14.99 . .
The Caddy $18.99 . .
Sewing Machine Table $24.99 . .
Crafty-Scrappers Workstation $24.99 . .
Subtotal: . . .
California residents add 8.25%sales tax: . . .
Add shipping & handling from chart above: . . .
Total Payment: . . .

Payment method: [ ]Visa [ ]MC [ ]Check [ ]Money Order

Card number________________________________________Expiration Date_____________
Thank you for your order. If paying by check, mail with completed order form to:
Pedal-Sta Company
365-A Mariposa Avenue, Sierra Madre, CA 91024

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