BUX CommCO Mail or Fax Order Form

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 Components, for
HAM Radio and Commercial Two-Way Radio.

O Money Order / Check (included with mail order).
O Credit card: (Number and expiration date required)

VISA: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

Discover: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

MstrCard: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

Expiration Date, (required) Month:_______ Year: ________

Name, (first-last):

__________________________________

Street:
__________________________________

City: _____________________State___
ZIP: __________-______

Callsign:_________
Phone: ________________
email:____________________________
Date:_____________________________
Signature:_________________________

Order No.:	Part or Model/Description	Quantity	Price Each ($)	TOTAL Price ($)













	Virginia Residents, add 4.5% VA tax.			$
		Sub Total		$
	S&H
		TOTAL

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.
The following rates apply to order shipped inside the continental USA; except Alaska:
Orders 0 to 2 pounds, $7.90 added to total.   Orders 2 to 5 pounds, $9.90 added to total.
Orders 5 to 15 pounds, $15.90 added to total.    Orders 15 to 35 pounds, $28.90 added to total.

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