HeartLand Boating Order Form
Name
Address
City, State, Zip
Telephone
Fax
E-mail
Payment Method: Payment Enclosed
Credit Card: Visa®       Mastercard®       American Express®

Credit Card Number:	Credit Card Expiration:
Name As Listed On Credit Card:

Qty	Item Description	Item Price
	Shipping & Handling*
	Total due (including S&H)

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Send completed form to:
HEARTLAND BOATING
319 N. 4th St., Suite 650, St. Louis, MO 63102
Or call 1-800-366-9630 or 314-241-4310 / Fax 314-241-4207

* Shipping & Handling (No S&H charges on HeartLand Boating subscriptions or back issues.)

$1.00 - 5.00 = $1 s&h	$200.01 - 250.00 = $16 s&h
$5.01 - 45.00 = $3 s&h	$250.01 - 300.00 = $18 s&h
$45.01 - 59.00 = $5 s&h	$300.01 - 350.00 = $21 s&h
$59.01 - 95.00 = $7 s&h	$350.01 - 400.00 = $23 s&h
$95.01 - 119.00 = $9 s&h	$400.01 - 450.00 = $25 s&h
$119.01 - 155.00 = $11 s&h	$450.01 - 500.00 = $28 s&h
$155.01 - 200.00 = $14 s&h