ConfederateBuckle.com
ORDER FORM

Toll Free  1-877-CSA-1860
         or 1-877-955-0055

Ship To  :
 Name      ___________________________         Phone # (____) _____________
              
 Address  _________________________           E-mail: __________________________
               
 City  ______________________   State  ______   Zip __________

Product Information:
Remember to include your belt size when ordering belts.
   Qty        Item # or code           Item Description                       Price Ea.    Total Price    
               
  Qty       Item # or code             Item Description                      Price Ea.    Total Price    
               
  Qty        Item # or code            Item Description                      Price Ea.    Total Price    
                

  Qty         Item # or code           Item Description                       Price Ea.    Total Price    
               
  Qty        Item # or code             Item Description                      Price Ea.    Total Price    
                  

 

Shipping Chart
Under $45 -  $5.50
$45 TO $75  -  $7.00
$75 TO $250  -  $10.00

    Subtotal  
    Shipping  
    Total       
Credit Card No.      Expiration Date 

or  Money Orders

How did you find our web site?

Remit To : 

A&T Leather
 234 Earls Rd.
Bryson City, NC 28713

               Please leave comments or instructions below :