ORDER FORM Cook's Original Go-To Tackle Storage System One Cook's Go-To System consists of two 12" 12-position Go-To racks, 12 hanger hooks, and all mounting hardware with installation and use instructions. Personal Information Name: __________________________ Address: __________________________ City: __________________________ State: __________________________ Zip Code: __________________________ Phone: __________________________ Email Address: __________________________ -------------------------------------------------------------------------------- Payment Information Payment Method: ___ Check ___ Money Order -------------------------------------------------------------------------------- Order Information Storage Systems Qty: _____ X $16.95 EA = _______ (Exclusive Price For Excel Bass Members) Qty: _____ X $19.95 EA = _______ (Price for Non-Excel Bass Members) Shipping & Handling $4.99 Grand Total _______ -------------------------------------------------------------------------------- Mail this form along with payment to: Chad Ingvalson 28160 County Road 107 Pequot Lakes, MN 56472