Order Form  
  Print, fill out form and mail to:  
  HolsterPatch Checks payable to:   
  3601 Robin rd Holsterpatch  
  Plano, TX 75075  
   
  Qty Color Type of gun Handedness cost ea. Total  
    Black Small auto right 6.99    
    Black Small auto left 6.99    
               
    White Small auto right 6.99    
    White Small auto left 6.99    
               
    Black Revolver right 6.99    
    Black Revolver left 6.99    
               
    White Revolver right 6.99    
    White Revolver left 6.99    
    Sub-Total $  
    Shipping    
  Sub-Total shipping charge  Total  $  
  $0.01 to $15.00 $2.75    
  $15.01 to $25.00 $3.25    
  $25.01 to $30.00 $4.50    
  $30.01 to $49.99 $5.85    
  $50.00 and up FREE Check amount enclosed $  
       
  Ship to    
  Name:          
  Address:          
             
  Phone:          
  email:          
       
       
  email contact: sales@holsterpatchconcept.com