Order Form

Please complete the following information. If you would like to submit your order via fax or mail, simply type your responses, print this page and send it to us. If you would like to submit your order via email, simply complete the form and press "submit." We will send you an email response to acknowledge that we have received your order.

PREVIEW INFORMATION:

We welcome preview orders of product to qualified institutions. Simply order the item you would like to preview and the product will ship to you for a 30-day trial period. An invoice will accompany each preview order. If you decide to purchase the product, simply pay the amount on the accompanying invoice. If you wish to return the item, please do so by the date indicated on the bottom of the invoice or the product will be considered a final purchase. Return items via UPS insured for their full value. The customer is responsible for cost in returning the preview item.

Purchase      Preview

HOW DID YOU FIND US?

      The Stanfield catalog -- back page Drawer Code if available:

      Referred by a friend or colleague

      Followed a link from another site -- site name:

      Using a Search Engine -- Please note the search criteria that
                    you used to find us:

       Which search engine did you use?  
      Google    Yahoo    MSN    Other:

SHIPPING AND BILLING INFORMATION:

Name

Title

Email

Phone Fax

Institution Name

Shipping

Address

City State Zip

Billing     Same as shipping

Address

City State Zip

PLEASE SEND ME:

Item 1: Order # Quantity

Title

Unit Price Total Price

Item 2: Order # Quantity

Title

Unit Price Total Price

Item 3: Order # Quantity

Title

Unit Price Total Price

Item 4: Order # Quantity

Title

Unit Price Total Price

SUB-TOTAL of all Items: CA Sales Tax / GST (Canada)

Shipping & Handling*

*We pay shipping and handling on all orders prepaid by check in the continental US.
If not prepaying, add 10% for shipping & handling, with a minimum of $7.00.

GRAND TOTAL:

PAYMENT INFORMATION:

Purchase Order #

Please bill me.

Credit card (This is not a secure server, please submit credit card orders via phone, fax, or mail.)

Credit card # Exp. Date (month/year) Security code

Name on Card

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