Please print this order form and mail or fax to:
Lekotek of Georgia,
1955 Cliff Valley Way, Suite 102,
Atlanta, GA 30329
Phone: (404) 633-3430, FAX: (404) 633-1242
Item # Description Qty Price Subtotal
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Order total: ___________________
Tax: ___________________
Shipping: ___________________
Total: ___________________
Name: ______________________________________________________________________________________
Address: ______________________________________________________________________________________
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Phone: _______________________________________________
Method of Payment:
Check enclosed (Make check payable to Lekotek of GA, Inc.) Send invoice
Shipping and Handling Charges:
Up to $50:
$ 4.00
$300 to $499: $17.00
$50 to $99: $ 7.50
$500 to $600: $21.00
$100 to $299: $12.50
Over $600: 2%