Salt of the Earth Weighted Gear Order Form
1
031  17th Street, Henderson, NE  68371
1. Enter
Quantity
2. Circle Weight
Choice
3. Circle ST for fine grade river stone    
4. Enter Fabric
Choice
or PB for poly bead
402-366-5883        FAX 1-800-345-0579
1. Enter
2. Circle chest size
3. Enter back measurement   
4. Enter Fabric
5. Choose Embedded Weight
& weight
or removable weights
Choice
6. Enter
Sub Total  
Quantity
& vest style
Weighted Vests
 
 
 
 
 
Sub Total
Total from all
pages
Neb
Only Tax 7%
Shipping
TOTAL
Check One: Check___  Visa___  Discover___  Master Card___  American Express____
Card Numbers:
Expiration Date: _______/________                  Security Code_______________
Name as it appears on card:

_____________________________     ____      _______________________________
Address
 
City                                                       State                                             ZIP
Mailing address




Contact Person________________________________________________________

Phone Number________________________________________________________

Email     ______________________________________________________________
USA SHIPPING
From (Lbs)
To (Lbs
Rate (USD)
0.01
7.00
10.00
7.01
15.00
15.00
15.01
23.00
23.00
23.01
30.00
30.00
30.01
and up
Please Call
:Vests:  20.00 each
Plushes: 10.00 each
Dolls:  10.00 each
CANADA SHIPPING
0.01
7.00
45.00
7.01
15.00
50.00
15.01
20.00
65.00
23.01
30.00
80.00
30.01
AND UP
Please Call
Vests: 35.00 each
Plushes 35.00 each
Dolls:  35.00 each
ALL OTHER COUNTRIES
0.01
7.00
65.00
7.01
15.00
70.00
15.01
23.00
85.00
23.01
30.00
95.00
30.01
and up
Please Call
Vests: 51.00 each
Plushes: 51.00 each
Dolls:  51.00 each
Multiple Vest Shipping: 20.00 each or 2 for 25.00
For international orders please call about vest shipping.
For Special Orders, please call Annie:  402-366-5883
  Torso:: 20     21     22     23     24
Style:  V/F  V/B   R/F   R/B   R/E
Length______
Weight_____
Embedded Weight____
Removable Weights___
$129.00
$159.00
 
  Torso: 25     26     27     28     29
Style:  V/F  V/B   R/F   R/B   R/E
Length______
Weight_____
fabric
Embedded Weight____
Removable Weights___
$139.00
$169.00
 
  Torso: 30     31     32     33     34
Style:  V/F  V/B   R/F   R/B   R/E
Length:______
Weight_____
fabric
Embedded Weight____
Removable Weights___
$149.00
$179.00
 
  Torso: 35     36     37     38     39
Style:  V/F  V/B   R/F   R/B   R/E
Length:______
Weight_____
fabric
Embedded Weight____
Removable Weights___
$159.00
$189.00
 
  Torso:: 40     41     24     43     44
Style:  V/F  V/B   R/F   R/B   R/E
Length:______
Weight_____
fabric
Embedded Weight____
----------------------------------
$169.00
----------
 
  Torso:: 45     46     46     48     49
Style:  V/F  V/B   R/F   R/B   R/E
Length:______
Weight_____
fabric
Embedded Weight____
---------------------------------
$179.00
----------
 
  Torso: 50     51     52     53     54
Style:  V/F  V/B   R/F   R/B   R/E
Length:______
Weight_____
fabric
Embedded Weight____
----------------------------
$199.00
----------
 
  Torso: 55    56     57     58     59
Style:  V/F  V/B   R/F   R/B   R/E
Length:______
Weight_____
fabric
Embedded Weight____
----------------------------
$250.00
-----------
 
 
Weighted Doll Vest for 18" Doll or Barby Doll
fabric
Embedded Weight____
----------------------------
$15.00
 
  Weighted Animal or Doll up to 5
pounds  (Shipping 10.00 each)
Doll__________
Animal_______
Description
$35.00
 
  Special Order (please call)
     
 
 
 
RUSH (each) If a RUSH is added to vest in an order, a rush must be added to each vest in the order.
$15.00
 
 
Size LB Lap
Blanket
20 x 24"
2, or 3 lbs
ST-PB
 
 
$32.00
 
 
4,5, 6, or 7 lbs
ST
 
 
$35.00
 
 
8, 9 or 10 lbs
ST
 
 
$40.60
 
 
Size T Blanket
24 x 42"
4,5, 6, or 7 lbs
ST - PB
 
 
$47.40
 
 
8, 9 or 10 lbs
ST
 
 
$52.00
 
 
Size A Blanket
36 x 42"
2, or 3 lbs
PB
 
 
$75.60
 
 
4, 5, 6, OR 7 lbs
ST - PB
 
 
$75.60
 
 
8,9,10,11, 12, 13, 14 or 15 lbs
ST
 
 
$79.40
 
 
Size SQ Blanket
42 x 42"
4, 5, 6, or 7 lbs
ST - PB
 
 
$88.20
 
 
8,9,10,11, 12, 13, 14 or 15 lbs
ST
 
 
$95.00
 
 

Size  B Blanket
42 x 50"
3 or 4 lbs
ST - PB
 
 
$105.00
 
 
5, 6 or 7 lbs
ST - PB
 
 
$105.00
 
 
8, 9, 10, 11 or 12 lbs
ST
 
 
$109.75
 
 
13, 14 or 15 lbs
ST
 
 
$114.00
 
 
Size C Blanket
42 x 60"
3 or 4 lbs
ST - PB
 
 
$126.00
 
  5, 6 or 7 lbs
ST - PB
    $132.00
 
 
8, 9 or 10 lbs
ST
 
 
$132.00
 
 
11, 12, 13, 14 or 15 lbs
ST
 
 
$139.50
 
 
Size CXL
Blanket
42 x 70"
5, 6 or 7 pounds
ST - PB
 
 
$147.00
 
  8, 9, 10 OR 11 LBS
ST
 
 
$152.30
 
 
12, 13, 14 or 15 lbs
ST
 
 
$155.00
 
 
16, 17, 18, 19 or 20 lbs
ST
 
 
$159.50
 
 
Size D Blanket  
58 x 75"
4, 5, 6 or 7 lbs
ST - PB
 
 
$179.00
 
 
8, 9 or 10 lbs
ST
 
 
$183.00
 
 
11, 12, 13, 14 or 15 lbs
ST
 
 
$189.40
 
 
16, 17, 18, 19 or 20 lbs
ST
 
 
$199.40
 
  Autism Awareness Earrings      1 pair $10.00        2 pair $18.00        3 pair $25.00
 
 
 
Weighted  Stuffed Animal   $35.00 ea          Weighted Doll  -  $45.00 ea           Shipping  -  $10.00 ea
   
  Lap Pad
from 12" by 14"
to 14 x 16"
2, 3 or 4 lbs
ST
 
 
$22.00
 
 
5, 6, 7 or 8 lbs
ST
 
 
$25.00
 
 
Lap Wrap
8 x 29"
9 x 31"
3 or 4 lbs
ST
 
 
$30.00
 
 
5, 6, 7 or 8 lbs
ST
 
 
$35.00
 
 
Shoulder Wrap
16 to 18" deep
3 or 4 lbs
ST
 
 
$39.00
 
 
5, 6, 7 or 8 lbs
ST
 
 
$42.00
 
  Character Prints or Special Prints 15.00 for blanket or vest,  $6.00 for small items
 
$12.00
 
  Pillow Case       1 for 20.00    -    2 for 35.00
 
$10.00
 
 
RUSH
Blankets or Vests
A RUSH pays overtime for a seamstress. If a
RUSH is added to one item, a RUSH must be
added to each item in your order.
$15.00
 
 
Lap Pads, Lap Wraps, Shoulder Wraps, sz LB & T
$6.00
 
Credit Card & or Shipping Information: Please print clearly - Fill out all fields.
Prices
5. Enter Sub
Total
We honor Check, Credit Card or Purchase Order with authorized signature.
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