Fax, Call & Mail in Order Form

AmesSciences_com Order Form

Ames Sciences, Inc.
507 Dover Road, Easton, MD 21601 Phone 410-820-8100 - FAX 410-820-8179
www.anythingSun.com --- www.AmesSciences.com --- sales@anythingSun.com

Print this form and use it for reference when calling in your order or mail or FAX it to us.

Ship To: (Print name and address)


Bill To: (If different from Ship To)
Name: ________________________________	Name: ________________________________
Address: ______________________________	E-mail: _______________________________
Address:_______________________________	Address: ______________________________
City:________________ State:___ Zip:______	Address: ______________________________
Telephone:_____________________________	City:__________________ State:___ Zip:____
Web Order # ___________________________	Daytime Telephone:_____________________

List fo Items:


Quantity:	Price per Item:	Total:
________________________________________	______	___________	________
________________________________________	______	___________	________
________________________________________	______	___________	________
________________________________________	______	___________	________
________________________________________	______	___________	________

Totals & Shipping:

Please circle carrier and shipping method.		Merchandise Total:______________
FedEx or UPS		5% Sales Tax (Only For Maryland Sales): ______________
Next Day Priority AM	2^nd Day	Plus Shipping (If unknown enter TBD): ______________
Next Day Standard	3 Day	FedEx and UPS can not deliver to Post Office Boxes.
Other ______________	UPS Ground	Some Items, such as monitors, ship only via FedEx. TOTAL:______________

Method and Authroziation of Payment:

Check or money order _____(Make payable to "Ames Sciences, Inc.")

American Express ___ Mastercard ___ Visa ___ PO# _________________

Credit card #____________________________, Security Code ________, & Exp. date: ___________

Credit Card Company Phone Number______________________________

Signature ____________________________________________________
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