EmailMe Form - Tristate Top Cushion Order Form

Name *

First Last

Email *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Phone *

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Credit Card Type *

VISA

MASTERCARD

AMERICAN EXPRESS

DISCOVER

Credit Card Number *

CCV Number *

Expiration Date *

MM / DD / YYYY

Butt Buffer Top Cushions

P-Pad 8X11 $57

Small 12X12 $77

Medium 12X16 $87

Large 14X18 $107

Select Top Cushion color

Select Top Cushion Fabric Type

Eagle Series/Wolf Edition

Select Eagle/Wolf

Specialty Cushions

Military Top Cushions

Select Size

Medium $135

Large $140

Shipping Options

Standard Ground UPS $14.00

3 Day UPS $22.00

Next day air- Air Prices will be actual cost and provided upon request.