Fax: 434 525 7818
or; Mail TO:
BUX CommCo
115  Luenburg Drive
Evington,  VA 24550

Internet: http://www.buxcommco.com

ORDER FORM

Antennas, Accessories, and Communications Components, for HAM Radio and Commercial Two-Way Radio Users.

O Money Order / Check (included with mail order).
O Credit card: (Number and expiration date required) FAX or MAIL.
VISA:   __ __ __ __   __ __ __ __   __ __ __ __   __ __ __ __
Discover: __ __ __ __   __ __ __ __   __ __ __ __   __ __ __ __
MasterCard: __ __ __ __   __ __ __ __   __ __ __ __   __ __ __ __
Expiration Date, (required)  Month:_______   Year: ________

Name, (first-last):

_______________________________________
Street:

_______________________________________

City: ________________________State_____

ZIP: __________-______

Callsign:_________ Phone: ________________
FAX: __________________________________
e-mail: _______________________________________
Date:__________________________________
Signature:______________________________

Order No.:

Part or Model/Description

Quantity Price Each ($) TOTAL Price ($)
         
         
         
         
         
         
         
         
         
         
         
         
         
 

Virginia Residents, add 4.5% VA tax.

$
   

Sub Total

$
  S&H  
       

                                                                                            Please print - fill in - fax or mail.
Important:
Shipping will be added according to weight chart below.   *Foreign orders will be charged according to carrier rates.
Shipments made inside the continental USA:
   Orders 0 to 2 pounds, $5.00 added to total.             Orders 2 to 5 pounds, $8.00 added to total.
   Orders 5 to 20 pounds, $15.00 added to total.         Orders 20 to 55 pounds, $27.00 added to total.

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