Use the Following Form to Place an Order

 
 
  Product Selection:
  Qty                                  Description                                  Price
  Insert Pack 1  ............. $
  Insert Pack 2 ............. $
  Insert Pack 3 ............. $
  Shipping Options:
  Shipping times (in business days) based on distance from our home office:
 Ground Parcel (1-3 weeks)    Expedited Ground + Confirmation # (5-15 days)
 Air Parcel (1-2 weeks)           XpressPost + Tracking # (3-7 days)
 Priority + Tracking # (1-2 days)
 
  Delivery Information:
 
  Name: 
  Company: 
  Address 1: 
  Address 2: 
  City:        State/Prov.: 
  Zip/Postal Code:    Country: 

  Voice Phone: 
  Fax: 
  Email: 
  
  Billing Information:
 

        Credit Card: 
         We will call you for the card number before shipping order.
  Cardholder Name: 
 
We will confirm with you by phone or email the total cost of your order + shipping. 
A shipping confirmation email will be sent to you by our shipping software when 
the package is shipped where applicable.