Chem Marin

If you are not sure what products we offer, check HERE

HOW TO ORDER

By Credit Card:
1. Fill out the order form below.
2. Include the name as it appears on the credit card and the correct
   billing address, even if it is the same as the shipping address.
3. Include the appropriate shipping charges.
4. E-mail your order to us.

Quant: 1 2 3 4 5 6 7 8 9 10 11 12 Desc: Cost Per: $ Total:$

Quant: 1 2 3 4 5 6 7 8 9 10 11 12 Desc: Cost Per: $ Total:$

Quant: 1 2 3 4 5 6 7 8 9 10 11 12 Desc: Cost Per: $ Total:$

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NET TOTAL COST FOR ITEMS.......................................................$

Shipping Cost............................................................................................... $6 $8 $10

Shipping & Insurance
     For order from $10 to $50   -  $6 shipping
               from $51 to $150  -  $8 shipping
               from $151 to $300 - $10 shipping
 

Subtotal...................................................................................................$

Tax (Pa. residents add 6% ....................................................................$

GRAND TOTAL INCLUDING SHIPPING AND TAX .....................

Payment Information

Credit card Visa MasterCard Discover American Express

Expiration Date 1 2 3 4 5 6 7 8 9 10 11 12 2000 2001 2002 2003 2004 2005 2006 2007

Credit Card Number

BILL TO INFORMATION:

NO P.O. BOXES !!

Name: (as it appears on Credit Card)

Email Address:

Street Address Line 1:

Street Address Line 2:

City, State and Zip:

Day Phone, with area code

SHIP TO INFORMATION (only if different from Bill To info)

WE SHIP UPS.... NO P.O. Boxes Please !

Name:

Street Address Line 1:

Street Address Line 2:

City, State and Zip:

Comments and Instructions