* PURCHASE ORDER FORM *

Please complete and print this purchase order form for any of the items on this web site.

Name:
Address:
City, State ZIP:
Phone:
Email:
   
Item1:
Item2:
Item3:
   
Total:
Shipping:*            If free shipping offered, please write FREE!
   
Grand Total:
   
* Please add 6% of the item's price as the shipping cost. Print out two copies and send one
  with your payment to: J. Parizek, 164 Jericho Tpk., Mineola, N. Y. 11501  516-739-8391 

 

Mail to:catalingems@aol.com  Tel: 516-739-8391
 

Please visit goodoldtimes.com for "Hart to find Collectables"
Coin-op Machines, Jukeboxes, Slot Machines, Catalin Radios and more!


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Fine Art Paintings, Prints, Posters, Glass and more!

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