Printable Order Form
Page 1 of 2
Salt of the Earth Weighted Gear
414 Road D 1050
Henderson, NE  68371
1. Enter
Quantity
2. Circle Weight
3. Circle ST for fine grade river stone    
4. Enter Fabric
5. Circle BA for body area weights
or PB for poly bead
or ED for  evenly distributed weights
Price     Sub Total  
402-366-5883        FAX 1-800-345-0579
1. Enter
2. Circle shest sizet
3. Enter back measurement   
4. Enter Fabric
5. Choose Embedded Weight
& weight
or removable weights
Choice
Price     Sub Total  
Printable Order Form    Page 2 of 2
  Torso:: 20     21     22     23     24
Style:  V/F  V/B   R/F   R/B   R/E
Length______
Weight_____
fabric
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____
----------------------------
   
  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
 
Choice
Quantity
& vest style
Choice
Weighted Vests
 
 
 
 
 
Sub Total

Total from all pages

Neb Tax 7%

Shipping

TOTAL
Check One       Visa____    Discover___    Master Card___    American Express____
Card Numbers:
Expiration Date: _______/________                  Security Code_______________
Mame as it appears on card:

_____________________________     ____      _______________________________
Address
 
City                                                       State                                             ZIP
Mailing address if different from billing:









Contact Person________________________________________________________

Phone Number________________________________________________________

Email :______________________________________________________________
Check One
Credit Card & Shipping Information:
Check or Money Order enclosed
 
Purchase Order Form enclosed
 
Credit Card information filled in
 
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:  15.00 each
CANADA AND MEXICO
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
Vest Shipping: 20.00 each or 2 for 25.00
For international orders please call about vest shipping.
 
Size LB Lap
Blanket
20 x 24"
2, or 3 lbs
ST-PB
 
ED
$39.00
 
 
4,5, 6, or 7 lbs
ST
 
ED
$39.00
 
 
8, 9 or 10 lbs
ST
 
ED
$42.00
 
 
Size T Blanket
24 x 42"
4,5, 6, or 7 lbs
ST - PB
 
ED
$45.00
 
 
8, 9 or 10 lbs
ST
 
ED
$49.00
 
 
Size A Blanket
36 x 42"
2, or 3 lbs
PB
 
BA - ED
$59.00
 
 
4, 5, 6, OR 7 lbs
ST - PB
 
BA - ED
$64.00
 
 
8,9,10,11, 12, 13, 14 or 15 lbs
ST
 
ED
$69.00
 
 
Size SQ Blanket
42 x 42"
4, 5, 6, or 7 lbs
ST - PB
 
ED
$75.00
 
 
8,9,10,11, 12, 13, 14 or 15 lbs
ST
 
ED
$79.00
 
 

Size  B Blanket
42 x 50"
3 or 4 lbs
ST - PB
 
BA
$85.00
 
 
5, 6 or 7 lbs
ST - PB
 
BA  - ED
$85.00
 
 
8, 9, 10, 11 or 12 lbs
ST
 
BA  - ED
$89.00
 
 
13, 14 or 15 lbs
ST
 
ED
$95.00
 
 
Size C Blanket
42 x 60"
4, 5, 6 or 7 lbs
ST - PB
 
BA  - ED
$99.00
 
 
8, 9 or 10 lbs
ST
 
BA  - ED
$104.00
 
 
11, 12, 13, 14 or 15 lbs
ST
 
BA  - ED
$115.00
 
 
Size CXL
Blanket
42 x 70"
5, 6 or 7 pounds
ST - PB
 
BA
$134.00
 
 
8, 9, 10, 11, 12, 13, 14 or 15 lbs
ST
 
BA  - ED
$139.00
 
 
16, 17, 18, 19 or 20 lbs
ST
 
ED
$144.00
 
 
Size D Blanket  
58 x 75"
5, 6 or 7 lbs
ST - PB
 
BA
$159.00
 
 
8, 9 or 10 lbs
ST
 
BA
$164.00
 
 
11, 12, 13, 14 or 15 lbs
ST
 
BA  - ED
$169.00
 
 
16, 17, 18, 19 or 20 lbs
ST
 
ED
$179.00
 
 
Autism Awareness Earrings
1 Pair  $8.00  -  2 Pair   $15.00  -  3 Pair  $10.00
   
  Lap Pad
from 12" by 14"
to 14 x 16"
2, 3 or 4 lbs
ST
 
ED
$22.00
 
 
5, 6, 7 or 8 lbs
ST
 
ED
$25.00
 
 
Lap Wrap
8 x 29"
9 x 31"
3 or 4 lbs
ST
 
ED
$30.00
 
 
5, 6, 7 or 8 lbs
ST
 
ED
$35.00
 
 
Shoulder Wrap
16 to 18" deep
3 or 4 lbs
ST
 
ED
$39.00
 
 
5, 6, 7 or 8 lbs
ST
 
ED
$42.00
 
  Character Prints or Special Prints 12.00
 
$12.00
 
  Pillow Case       1 for 15.00    -    2 for 25.00
 
 
 
 
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
 
For Special Orders, please call Annie:  402-366-5883