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Instructions
Print this form, then fill in your address and payment information in the space
provided and fax or mail it to us at:
SCIENCE KIT INTERNATIONAL Order Toll-Free
PO BOX 92912 -- 51 W HENRIETTA ROAD Phone: 585-321-9104 Fax: 585-321-9105
ROCHESTER, NY 14692
http://www.sciencekit.com/international
REQUEST A QUOTE FORM FOR DATE:[[DATE]]
www.sciencekit.com
BILL TO: SHIP TO:
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Name Name
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Company Company
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Street Address Street Address (Do not use a PO Box)
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Street Address (line 2) Street Address (line 2)
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Street Address (line 3) Street Address (line 3)
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City State ZIP City State ZIP
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Phone Ext. Phone Ext.
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Fax Fax
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E-mail E-mail
PAYMENT:
_____ Check Enclosed: $_________________ (Make Payable to Science Kit)
_____ Credit Card: ___VISA ___MasterCard
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Shipping Method (if other than Standard): ___Next Day
Please tell us why you chose the print/fax option instead of completing this order
online with a credit card:
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THANK YOU FOR ORDERING FROM SCIENCE KIT INTERNATIONAL
ORDER PRINT OUT -- Science Kit -- 5/23/2012 |
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