Name___________________________________________________________
Street____________________________________________________________
City_________________________State_________________Zip____________

Ship To: (if different from above)
Name___________________________________________________________
Street____________________________________________________________
City_________________________State_________________Zip___________
Phone (______)__________________fax (______)_______________________
Email:______________________________________

Bob Earl Racing Inc.
Quantity Description Price Amount
 
VRC............................ Color: Red ( __) Black (__ )
$299.00  

*Wheel to be used*___________________________

 
  Monitor Stand.......... Color:Red ( __) Black (__ ) $99.00  
G25 Shifter Mount $45.00  
Sub total
 

Plus CA. sales tax--- 7.25% (CA. residence only)

 
Plus shipping
(VRC is $65 Ea. outside CA, $30 Ea. in CA This includes a $10 Charge for Packaging materials
(Monitor Stand is $33 outside CA or $20 in Ca.)*or see below for shipping
 
Total Due
 

Payment Method: If using Paypal Print and fill out this form and fax to us, you can pay amount using Paypal after emailing us for our paypal account information.

Check One: MC(__) Visa(__) Discover(__) Check / Money Order (__) Paypal(__)
Card #:  
Expiration Month:_____ Year:_____
Name on card:  

Make Checks or money orders payable to:
Bob Earl Racing Inc.
52 Stasia Dr., Novato Calif. 94947
707-237-2305 FAX

To get an accurate shipping cost, click the order button and enter your information like you are going to order online, then after it shows the shipping just quit before you need to enter the credit card information.