Manual Order Form

HOME Welcome to our online order form. This form should be used if you want to pay by check or credit card or invoiced at a later date. It is designed to be opened in a new window so you can view products in another window then simply add them here. This form will not calculate shipping costs nor charge the purchase to either PayPal or Google Checkout. Upon completing this form, it will be sent to us where we will calculate the shipping, make any necessary corrections, then we will invoice you using the method you select below. Upon payment of the invoice, your order will be shipped and you will be provided with a tracking number. DO NOT INCLUDE ANY CREDIT CARD OR FINANCIAL INSTITUTION INFORMATION WITH THIS FORM. We will contact you to process payment information if paying by credit card as it is not safe to send such information via email. If you would like to order more than six items, simply submit the first six then, using your browser's back button, return to the form and update the items. Your browser should retain and the billing, shipping and payment method information.
Description	Quantity	Unit Price	Unit Total Price
1 -
2 -
3 -
4 -
5 -
6 -

		Sub Total
		Tax
(Total excludes shipping which will be added to the invoice.)		Total

Billing Information - All fields are required except Company name, Address Two and Phone Extension.		Shipping Information Check box if shipping information is same as billing.
First Name:		First Name:
Last Name:		Last Name:
Company Name:		Company Name:
Address One:		Address One:
Address Two:		Address Two:
City:		City:
State/Province:		State/Province:
Zip/Postal Code:		Zip/Postal Code:
Country:		Country:
Phone (123-456-7890 format):	Ext:	Phone:	Ext:
Email:		Email:



If claiming Tax Exemption, please enter tax exempt number here:
Select Shipping Method: Standard UPS Ground UPS Third Day Air UPS Second Day Air UPS Next Day Air International
Select Payment Service through which you will be invoiced: To pay online, select either or To pay by credit card or check, select either Email Invoice or Snail Mail Invoice Enter Purchase Order Number if applicable

Enter comments and special instructions here.* *Do not enter web or email addresses here as the form will be rejected.
If this is a supplement to a previous order, please check
Verification Code:		Enter the characters in red in this field. CASE SENSITIVE!
NOTICE: For security and verification, your IP Address and Remote User Name will be recorded upon submission of this form.