Please Print, Fill out, and email to | |||||||
Earthstone.Com
Claremont, California |
sales@earthstone.com
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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 | ||||||
(For order receipt confirmation.) | |||||||
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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 |
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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: | |||||||