EKOOSTIK HOOKAH SHOP MAIL/FAX ORDER FORM - PAGE 2 OF 2
------------------------------------------------------

MERCHANDISE:

Please check our online store at http://shop.ekoostik.com for a complete list
of all our current, in-stock merchandise - including available sizes. When
ordering shirts, please specify size in the ITEM area. When ordering schwalights
or stickers, please specify color.

					HOW	PRICE		TOTAL
CODE	ITEM				MANY?	EACH		PRICE

____	____________________________	_____	$__________	$__________

____	____________________________	_____	$__________	$__________

____	____________________________	_____	$__________	$__________

____	____________________________	_____	$__________	$__________

____	____________________________	_____	$__________	$__________

____	____________________________	_____	$__________	$__________

____	____________________________	_____	$__________	$__________

____	____________________________	_____	$__________	$__________

____	____________________________	_____	$__________	$__________

____	____________________________	_____	$__________	$__________

MERCHANDISE TOTAL						$__________

SHIPPING:

All orders are sent via First Class mail. Please alllow 3-5 weeks for delivery.
Shipping costs are calculated with a base charge of $2.99 per order plus a
per-item charge. Please fill out the chart below to calculate your total shipping.

Base Shipping Cost		$	2.99

#_____ of CDs @ $1.75 each	$___________

#_____ of hats @ $1.25 each	$___________

#_____ of shirts @ $2.50 each	$___________

#_____ of posters @ $2.00 each	$___________

Stickers, patches, schwalights	$	FREE

International Orders		$     +10.00

TOTAL SHIPPING			$___________