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Dave's - D. C. W. Collection           Phone: 1-800-346-6718 or 858-513-6551
P. O. Box 500850                       Fax:   (858) 513-6557 
San Diego, CA 92150-0850


SOLD TO:                                 SHIP TO: (If not the same)

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Name                                     Name

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Address                                  Address

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City, State, Zip                         City, State, Zip

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Phone Number


|                                              |     |    P  R  I  C  E    |
| Item                                         | QTY |   Each   |  Total   |
|----------------------------------------------+-----+----------+----------|
|                                              |     |          |          |
|----------------------------------------------+-----+----------+----------|
|                                              |     |          |          |
|----------------------------------------------+-----+----------+----------|
|                                              |     |          |          |
|----------------------------------------------+-----+----------+----------|
|                                              |     |          |          |
|----------------------------------------------+-----+----------+----------|
|                                              |     |          |          |
|----------------------------------------------+-----+----------+----------|
|                                              |     |          |          |
|----------------------------------------------+-----+----------+----------|
|                                              |     |          |          |
----------------------------------------------------------------+----------|
                                                      SUB TOTAL |          |
                                                                |----------|
                 CA orders: add 8.00% sales tax if under $1,500 |          |
                                                                |----------|
                 If under $1,000, add $5.00 Shipping & Handling |          |
                                                                |----------|
                                                          Total |          |
                                                                ------------
Alternate Choices:_________________________________________________________
                  _________________________________________________________
PAYMENT METHOD:
( ) Check Enclosed, Make check payable to "Dave's - D.C.W. Collection".
( ) MasterCard, Visa Cards or American Express

Card Number: _____________________________________ CVV2 Number:_____________

Expiration Date: ______________

Signature: ______________________________________________________________