ORDER FORM 

Visa, MasterCard, Discover, Paypal, Cashier checks and Money orders shipped
  within 24 hours while personal checks take 7 working days to clear.
Send Paypal payments to race@racediecast.com, use the paypal website to send payment.
 
      Phone  337-457-4498      
Monday thru Friday:    9:00 A.M. to 5:00 P.M.   Central Standard Time
 
(Make personal, company or cashier checks or money orders payable to:)
Circle Track Racing Inc.   127 Edmund Lane,  Eunice, La. 70535

Please Enter Your Name, Address, Phone and E-Mail Information Here
Name:
Address:

City, State, Zip:

,.
Phone: xxx-xxx-xxxx

Fax:

xxx-xxx-xxxx
E-mail:

Please Enter Your Payment Information Here

Payment Method: 
VISA  MASTER CARD  CHECK  MONEY ORDER
Name on Card: 
 
Card Number: 
   
3 digit CVC Number: 
             4 digit Expiration Date: 

 Please Fill In Your Order Here

Qty Car # Description Price Per Ext Price

Sub Total

Shipping & Handling (See Below)

Sub Total With Shipping & Handling
8.7% Sales Tax (If Applicable)
Total Amount Of Order
Please List Your Comments Or Special Instructions Here
         
 

USA ONLY   USPS  PRIORITY SHIPPING  CHARGES
PRICE PER PACKAGE

  $ 1.00 - $24.50 --  $10.00

 $24.51 - $34.50

--  $12.00
 $34.51 - $59.50 --  $14.00
  $59.51 - $119.50 --  $16.00
$119.51 - $179.50 --  $18.00
$179.51- $239.50 --  $20.00
$239.51 - $349.50 -- $24.00
$349.51 - $449.50

--

$28.00
$449.51 - $649.50 -- $32.00
$649.51 - $849.50 -- $36.00
$849.51 - $999.50 -- $40.00
$999.51  UP -- $46.00
Please use this chart for S & H charges
 LOUISIANA RESIDENCE MUST ADD  8.7 % TAX

"THANK YOU" for your order - check back often for new arrivals and  HAVE A NICE DAY!

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