Tyless TM Mail
Order Form
                        Ship To:                                                                                        Bill To: (If Different)


Name:
  ___________________________________________              Name:  _____________________________________________



Company:  _________________________________________            Company:  __________________________________________



Address 1:  ________________________________________             Address 1:  _________________________________________



Address 2:  ________________________________________             Address 2:  _________________________________________



City:  ______________________________________________            City:  _______________________________________________



State:  
_______       Zipcode:  __________________________           State:  ______      Zipcode:  _____________________________



Email Address:  _____________________________________           Telephone:  
__________________________________________   
                      
Please Refer to Order Page for Colors and Sizes   
                              Available
                              Convertibles Pricing

No. Of Pairs        $ Each                S&H                    Total Price

   1                   $5.95                 $2.25                        $8.20
   2                   $5.45                 $2.25                      $13.15
   3                   $4.95                 $2.45                      $17.30
   4                   $4.95                 $2.65                      $22.45
   5                   $4.95                 $2.85                      $27.55
   6                   $4.95                 $3.00                      $32.70     

Additional pairs may be purchased for $4.95 each with no additional
charges for shipping and handling.  You may mix colors and sizes.
Lace Size
Lace Color
Convert or +
Quantity
       
       
       
       
                            Convertibles Plus Pricing

No. Of Pairs        $ Each                S&H                    Total Price

   1                   $7.95                 $2.25                      $10.20
   2                   $7.45                 $2.60                      $17.50
   3                   $6.95                 $2.75                      $23.60
   4                   $6.95                 $3.10                      $30.90
   5                   $6.95                 $3.30                      $38.05
   6                   $6.95                 $3.60                      $45.30     

Additional pairs may be purchased for $6.95 each with no additional
charges for shipping and handling.  You may mix colors and sizes.
Make checks to:  Tyless