Please Print, Fill out, and email to
Earthstone.Com
Claremont, California

sales@earthstone.com

 

Order Form
Sold / Ship To  
Customer ID #     Page _____ of _____
(New customers please provide copy of Seller's Permit and Resale Certificate.)
Company Name     Date    
Contact Person     Tel    
Shipping Address     Fax    
      email    
            (For order receipt confirmation.)
  Qty Item Number & Description Price Extend
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International customer must agree to pay duties plus 6% surcharge if the shipping carrier has difficulties to collect duties from you and charge us after delivery. See FAQ for details. SubTotal   
Payment Method: ____ Visa; ____ MasterCard (Check one) Minimum Order $10.00.
Availability subject to change.
Quantity discount will be applied automatically per our policy.
Freight and insurance will be added on every shipment.
No re-stocking fee if return in 10 days. See FAQ for details.
Card Number   3-digit V-Code
on back of card		  
Card Holder Name   Exp.         / /
Signature   X      
  Billing Address          
  (Required only if different from the Shipping Address provided above.)
We usually can ship out your order in 1-3 business days. Please choose how you want us to process your order.
  Standard: ___ Don't call if the order is complete; However, please call if the order can't be completed as required.
  Expedite: ___ Don't call; ship out whatever in stock A.S.A.P.; Confirm: ___ Always call to confirm availability and total.
  Shipped via:___USPS, ___UPS, ___FedEx;  Delivery: 1. ___Next Day; 2. ___2nd Day; 3. ___3rd Day; 4. ___Ground (USPS/UPS only)
  Special Saturday Delivery: _____ (For UPS/Fedex Next Day delivery only. Additional charge applied.)
  Please attach additional page(s) for more items and special instructions: