Print This Form and Mail to:
InterMark
America Corporation
6947 Coal Creek Parkway SE #142
Newcastle, WA 98059
Note: If paying by check, you must allow time for the check to clear first. Using a money order allows you to receive your order much faster!
SHIP TO:
Name:_______________________________________________________
Address:_____________________________________________________
City:________________________________________________________
State:______________________ Zip:______________________________
Credit Card Billing Address (only if using a credit card)
Name:_______________________________________________________
Address:_____________________________________________________
City:________________________________________________________
State:______________________ Zip:______________________________
Credit Card Information:
Credit Card Number:
______________________________ Exp: ___________________
Name On Card: _________________________________________________________
Products You Would Like To Order:
Product Name:___________________________
Qty:_______ Price:_____ Total:_______
Product Name:___________________________ Qty:_______ Price:_____ Total:_______
Product Name:___________________________ Qty:_______ Price:_____ Total:_______
Product Name:___________________________ Qty:_______ Price:_____ Total:_______
Product Name:___________________________ Qty:_______ Price:_____ Total:_______
Tax (8.8% - Pay this ONLY if you live in the state of Washington)...........Tax:
_______
Shipping & Handling: ............................................................................:________
Order Total.........................................................................................:________
Shipping
& Handing charges:
-Unless you request otherwise, our "default shipping" is U.S. Mail, First Class.
Typical shipping time (not guaranteed) is 3-5 days.
| Total Product | Up to $50 | $50- $100 | $100-$200 | $200+ |
| 3-5 Days | Free! | $8.70 | $17.40 | $25.80 |
| 2nd day | $20.00 | $26.71 | $33.50 | $39.91 |
| Next Day | $30.00 | $37.71 | $41.75 | $55.71 |
International |
$40.00 | $40.00 |