Fax this form to: 1-866-631-3067 (available 24 hours per day)
 Or mail to: Deutscheshaus/GST Co. 2412 145th Street, Luck, WI 54853
Orders accepted Internationally.
Make checks payable to GST Co.

 
Billing Information
First Name: 
Last Name: 
Street: 
City: 
 State:  Zip: 
  Day Phone: 
   Evening Phone: 
Fax:  Email:
Ship to (Complete only if different from above address)
Full Name: 
       Street: 
         City: 
 State: Zip: 
Select Payment
Name on Card: 
      Exp. Date: mm
 yy 
Card number:    
 
Visa  Master Card American Express Discover Check

  By signing your name, you agree to pay GST Co.
Please make checks out to GST Co.


(Required) Signature: ___________________________________

Please indicate the following:

Item #
QTY
 Description 
Price/Unit
     Total 
Total of items before tax and shipping added:
Subtotal:
Minnesota Residents MUST add 6.5% sales tax
MN Tax:
Estimated
 Shipping:
Print it & Fax it to: 1-866-631-3067
Total: