HOME • SHIPPING & PAYMENT TERMS • ORDER FORM • ONLINE STORE

If you would like to order by mail with a check or money order, please print out this form and mail with your payment. See payment and mailing information at the bottom of the form. It is highly recommended that you email us at mck@sover.net before sending your order to verify that items are in stock. We will gladly put them aside for you pending receipt of payment. If payment is not received after 10 days, the items will be put back into stock.

For payment by credit card or e-check (via Paypal only!) please purchase through our online store at http://shop.vendio.com/kozmyck

Ship to:

Name:_________________________________

Address:_______________________________

______________________________________

City:___________________________________

State:________ Zip Code:_________________

Country:___________________

*Email:_____________________________

Phone:____________________________

*This information is needed in case we need to contact you about your order.

How did you find us online?
__ Referral by Friend/Relative
__ Search Engine:_____________
__ Other:___________________


 Qty

Description

Price per Unit

 Extended Price
       
       
       
       
       
       
       
       
       

 

  Sub-Total

  
 

  S&H

  
 

  Insurance

  
 

TOTAL

  
     

Shipping & Handling (U.S.A. only):
Up to $24.99 = $1.50 (First Class Mail)
$25.00 to $49.99 = $2.00 (First Class Mail)
$50.00 to $74.99 = $2.50 (First Class Mail)
$75.00 to $99.99 = $3.00 (First Class Mail)
$100.00 and up = $4.50 (USPS Priority Mail)

Insurance Fees:
Up to $50.00 = $1.30
$50.01 to $100.00 = $2.20
$100.01 to $200.00 = $3.20

Checks & Money Orders should be made payable to the name below. Do NOT put kozmyck as the Payee or your check may be returned. Mail completed form with payment to:

Michelle Krane
PO Box 268
Shaftsbury, VT 05262

Accepted forms of payment include money order, bank check or personal check (personal check may be subject to a waiting period to clear before item is shipped).

Credit card and e-check payments are taken only through Paypal.com