Printable Order Form

Please print and complete this form to help organize your order. When completed, you may:

Make checks payable to Sciencekits.com, Inc.

Name:________________________________________________________________

Company/School/Gov Agency Name:______________________________________

Address:_____________________________________________________________
 
City:_____________________State:___________________ZIP:______________
 
Daytime Telephone Number: (_______)__________________________________
 
Evening Telephone Number: (_______)__________________________________
 
E-Mail Address:______________________________________________________
 
How did you find us? ________________________________________________
 
 Item                                            Unit          Total 
 Number Quantity     Description                 Price         Price 
  
 ____________________________________________________________________
 
 ____________________________________________________________________
 
 ____________________________________________________________________
 
 ____________________________________________________________________
 
 ____________________________________________________________________
 
 ____________________________________________________________________
 
                                     Merchandise Total ______________
 
                   Maryland Residents Add 6% Sales Tax ______________
 
                                  Shipping and Handling _____________
 
                                                 TOTAL ______________
For charge card orders by mail or fax:
 
Charge Card Number:_______________________________________________
 
Expiration Date:_________ Signature:______________________________
 
American Express & Optima only: Card Identification Number: ______ 

The Card Identification Number is four digits printed above the embossed charge card number on American Express and Optima cards.





Shipping & Handling Charges (USA Only)

Orders up to $16.99  . . . . . . . . $7.95
Orders from $17.00 to $19.99 . . . . $8.95
Orders from $20.00 to $24.99 . . . . $9.95
Orders from $25.00 to $39.99 . . . . $10.95
Orders from $40.00 to $49.99  . . .  $11.95
Orders from $50.00 to $69.99  . . .  $12.95
Orders from $70.00 to $130.00  . . . $13.95
Orders Over $130.00 . . . . . . . .  10% of Order