Order Kit & Menu

Order Kit & Menu

Would you like to order a product ? *	Yes No
Ultimate Kit - 3 day-4 person @ $ 375.00 delivered	Yes No
How many Ultimate kits ?
Auto 3day-4person Survival kit @ $ 349.00 delivered	Yes No
How many Auto kits ?
Sanipotti Portable Toilet @ $ 129.00 delivered ?	Yes No
How many Sanipotti Portable Toilets ?
Would you like to choose the food items in your Ultimate Emergency kit ?	Yes No
Canned Fruits	Yes No
Canned Vegetables	Yes No
Beef Stew w/vegetables	Yes No
Canned Salmon	Yes No
Canned Tuna	Yes No
Soup	Yes No
If yes please list 3 favorite types
Potato dishes	Yes No
Rice dishes	Yes No
Energy Bars	Yes No
Dried fruit & nuts	Yes No
Sports Drinks	Yes No
Fruit drinks	Yes No
Please list any extra items you prefer
You name *
Street address *
City *
State & zip code *
Telephone number *
Email address
Fax number
How should we contact you to confirm the order ?