| SKU | PRODUCT NAME | PRICE | QTY | TOTAL |
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| Total : |
***If you are a North Carolina resident, sales tax will be added to the total cost at the time the order is processed.
Please select one of the shipping options below.
| FedEx 2 Day - Continental US* | $15.00 / pkg |
| FedEx Overnight - Continental US* | $24.00 / pkg |
| FedEx International - Canada | $30.00 / pkg |
| FedEx International - Other | $40.00 / pkg |
| International e-Delivery** | $0.00 |
* Continental US does NOT include Canada.
** International electronic delivery is ONLY available when
ordering via Wire Transfer
Visa
Master Card
American
Express
Credit Card Number:
Your billing address must be entered exactly as it appears on your credit card statement. Please check your statement for accuracy to avoid delays in processing your order.
Company Name Address
Phone Number Fax Number |
If shipping information is different than billing information, your order may be delayed for verification. Due to shipper restrictions we cannot deliver to P.O. Boxes.
Company Name Address
|
When you have competed the order form, simply fax your order to 919.287.2230, or mail it to 5007 Southpark Drive, Suite 240, Durham, NC 27713, USA
*Please verify that you have selected the correct product before submitting your order. All sales are final: once purchased, no product may be returned or exchanged. Thank You!