Lab Essentials' Order Form |
| NAME: |
| BILLING
ADDRESS:
|
SHIPPING ADDRESS: |
| TELEPHONE NO: |
| EMAIL ADDRESS: |
| CREDIT CARD # | EXP. DATE: |
| SIGNATURE | |
| ITEMS
PURCHASED
|
QUANTITY | PRICE | TOTAL
|
| SHIPPING & HANDLING (IF APPLICABLE): $3.80 for orders under $25, $5.00 for orders $25-$50, Free shipping for orders over $50 |
| SALES TAX (GA RESIDENTS ADD 6%): |
| TOTAL AMOUNT OF ORDER |
Lab Essentials will email you with a confirmation of your order and expected ship date. If you do not receive confirmation within 12 hours of faxing your order, please re-fax or contact us by phone or email.