Printable Order Form

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

• Call toll-free 1-800-588-9880, 24 hours a day, every day. Please have your credit card and order selection(s) ready when you call.
• Fax this order form to us at 1-301-294-8969.
• Mail this form to: ScienceKits.com, Inc., P.O. Box 1542, Rockville, MD 20849-1542

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 $17.00  . . . . . . . . . . . . $6.95
Orders from $17.01 to $20.00 . . . . . $7.95
Orders from $20.01 to $30.00 . . . . . $8.95
Orders from $30.01 to $40.00 . . . . . $9.95
Orders from $40.01 to $50.00 . . . .  $10.95
Orders from $50.01 to $55.00 . . . .  $11.95
Orders from $55.01 to $130.00  . . . $12.95
Orders Over $130.00 . . . . . .  10% of Order