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*First Name   First Name
*Last Name   Last Name
Care of Care of
*Address Address
*City City
State/Province State/Province
*Country/Region Country/Region
*Postal/Zip Code Postal/Zip Code
Credit Card Info Contact Info
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1-800 Number
on Back of Card		    
Order Summary
Designs Chart Styles Chart
Color Chart Size Chart
United States Shipping Charges
Up To $30.00 : $3.95
$30.01-$60.00 : $5.95
$60.01-$90.00 : $7.95
$90.01-$120.00 : $9.95
$120.01-$160.00 : $11.95
$160.01-$200.00 : $12.95
Over $200.00 : $14.95

Canada Shipping Charges
Up To $66.99 : $5.50
$67.00-$130.99 : $8.25
Over $131.00 : $9.25

International Shipping Charges
Up To $32.99 : $8.60
$33.00-$66.99 : $15.00
$67.00-$96.99 : $21.80
$97.00-$130.99 : $27.40
Over $131.00 : $34.00
Subtotal $

NY Billing Address Add 8.25% Tax $

Shipping $

Total $
Fax  561.365.8470
Phone  800.388.1969
 		Mailing Address
Chakratees
560 Lorimer Street, 1st Floor
Brooklyn, NY 11211