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Eliese Research Mail Order Form

  Mail Order Form

                         To order by US mail, print out this form, fill in the blanks, mail it in with your cash, check or money order.                      

See below to calculate shipping and Texas sales tax.

Product Name

Price Each

Quantity

Total

Drain Sling-U

$35.00

 

 
Drain Pouch

$19.50

   
EZ Towel

$12.00

   

Sub Total:

 

Shipping/Handling:

 

Texas Sales Tax at 8.25%: 

 

Your Total:

 

Calculate your shipping and handling cost by adding $7.00 for the first item and $1.00 each for additional items.                                          (Example - To order three items, add $7.00 for the first item, then $2.00 for the additional items bringing your total shipping/handling to $9.00)

Calculate Texas Sales Tax (Texas Residents Only) by Multiplying the subtotal by .0825 then round up to the next penny.

Mail the above form with your check or money order to:

Eliese Research

59 Elm CT

Lake Jackson, TX   77566

 

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Email: info@elieseresearch.com

 

 

© 2011 Debbie Bachelder DBA Eliese Research