Quantity
Circle Weight Choice
Fabric Choice
 
 
 
 
Sub Total
Shipping
Neb Only Tax 7%
TOTAL
Check One: Check___  Visa___  Discover___  Master Card___  American Express____
Card Numbers:
Expiration Date: _______/________                  Security Code_______________
Name as it appears on card:

_____________________________     ____      _______________________________
Billing Address
 
City                                                       State                                             ZIP
Mailing address




Contact Person
________________________________________________________

Phone Number________________________________________________________

Email     ______________________________________________________________
USA SHIPPING
From 1.00
To $ 114.00
$10.00*
 From $ 115.00
To $ 149.00
$15.00*
$150.00
or more
Free*
*Weighted Plush
  $10.00 each
*Weighted  Vest
  $15.00 each
CANADA SHIPPING
0.01
20.00
49.00
20.01
40.00
85.00
40.01
60.00
155.00
60.01
80.00
180.00
30.01
or more
Please Call
 1 or 2 Vests: 49..00
1 or 2 Plushes
49.00 each
 1 or 2 Dolls:  49.00
each
NO SHIPPING TO OTHER COUNTRIES
 
Weighted Blanket
size Large
48 x 75
6  7  8  9  10  11  12  13  14  15  
16  17  18  19  20
 

$
199.40
   
 
Weighted Blanket
size Tall
42 x 70
6  7  8  9  10  11  12  13  14  15  
16  17  18  19  20
 
$159.50
   
 
Weighted Blanket
size Average
42 x 60
6  7  8  9  10  11  12  13  14  15
 
$139.50
   
 
Weighted Blanket
size Youth
42 x 50
6  7  8  9  10  11  12  13  14  15
 
$114.00
   
 
Weighted Blanket
size Travel
 42 x 42
5  6  7  8  9  10  11  12  13  14  
15
 
$95.00
   
 
Weighted Blanket
size Toddler
36 x 42
4  5  6  7  8  9  10  11  12  13  
14  15
 
$79.40
   
 
Weighted Blanket
size Shoulder
24 x 42
4  5  6  7  8  9  10
 
$52.00
   
 
Weighted Blanket size Lap
20 x 24
2  3  4  5  6  7  8
 
$40.60
   
 
 
 
 
 
   
 
Weighted Lap Pad
14 x 16
2  3  4  5  6  7  8
 
$25.00
   
 
Weighted Lap Wrap
9 x 30
2  3  4  5  6  7  8
 
$35.00
   
 
Weighted Shoulder Wrap
16 to 18 accross
2  3  4  5  6  7  8
 
$42.00
   
 
Weighted Plush
2  3  4  5
shipping - $10.00 each
$45.00
   
WEIGHTED VESTS     Shipping $ 15.00 each
  Torso:   20    21    22    23    24
Length_____  Weight_____
Style: V/F    V/B    R/F    R/B    R/E
Fabric Choice:
Embedded
$129.00
   
Removable
$159.00
   
  Torso:   25     26     27     28     29
Length_____  Weight_____
Style: V/F    V/B    R/F    R/B    R/E
Fabric Choice:
Embedded
$139.00
   
Removable
$169.00
   
  Torso:   30     31     32     33     34
Length_____  Weight_____
Style: V/F    V/B    R/F    R/B    R/E
Fabric Choice:
Embedded
$149.00
   
Removable
$179.00
   
  Torso:  35     36     37     38     39
Length_____  Weight_____
Style: V/F    V/B    R/F    R/B    R/E
Fabric Choice:
Embedded
$159.00
   
Removable
$189.00
   
  Torso:   40     41     42     43     44     
Length_____  Weight_____
Style: V/F    V/B    R/F    R/B    R/E
Fabric Choice:
Embedded
$169.00
   
---
 
   
  Torso:   45     46     47     48     49
Length_____  Weight_____
Style: V/F    V/B    R/F    R/B    R/E
Fabric Choice:
Embedded
$179.00
   
---
 
   
  Torso:  50     51     52     53     54
Length_____  Weight_____
Style: V/F    V/B    R/F    R/B    R/E
Fabric Choice:
Embedded
$199.00
   
---
 
   
  Torso:   55     56     57     58     59
Length_____  Weight_____
Style: V/F    V/B    R/F    R/B    R/E
Fabric Choice:
Embedded
$250.00
   
---
     
 Please print clearly
Prices
Sub Total   Total
We honor Check, Credit Card or Purchase Order with authorized signature.
Salt of th Earth Weighted Gear - Order Form
1031 17th St - Henderson, NE  68371

Salt of the Earth Weighted Gear
1031 17th Street
Henderson, NE  68371


Phone - 402-366-5883
Fax - 1-800-345-0579