|
| Name ___________________________________________ | |
| Street ___________________________________________ | |
| City ___________________ | State ___________________ |
| Zip ____________________ | Country _________________ |
| Telephone ______________ | E-mail _________________ |
| QTY | DESCRIPTION | AMOUNT |
| _____ | Fixed Seat Model | $4,600.00 |
| _____ | Fixed Seat/Sliding Seat Combination | $5,900.00 |
| _____ | Fixed Seat/Sliding Seat-Ready | $4,700.00 |
| Sales Tax (if applicable) | ________ | |
| Total | ________ |
| SPECIFY PAYMENT METHOD: Money Order:___ Check:___ (Make check/money order payable to Middle Path Boats) MasterCard:___ VISA:___ Discover/Novus:___ American Express:___ | |
| Account Number: | ![]() |
| Expiration Date: | ![]() |
| Signature: _________________________________________ | |
I the UNDERSIGNED acknowledge and understand fully the above written information and that the
accompanying deposit for the purchase of a boat is non-refundable subject to the conditions stated above:
Signature: _______________________________________Date:_______
| Home Page | About The Skua | FAQ | Order Information | E-Mail |