Term USAOrder Form
HOME
PRICING
ORDER
PRICE QUOTE
RESEARCH
CONTACT
Date  
BILLING ADDRESS: SHIPPING ADDRESS:
(if different from billing)
Name Name
Street Address Street Address
   
City City
State State
Zip/Country Code Zip/Country Code
Country Country
Phone Phone
Fax Fax
E-mail E-mail
P.O. Number
ITEMS TO ORDER:
*Please designate item and purity
Item    Quantity    Price Per    Subtotal  
Item    Quantity    Price Per    Subtotal  
Item    Quantity    Price Per    Subtotal  
Item    Quantity    Price Per    Subtotal  
Item    Quantity    Price Per    Subtotal  

Your quote, with Tax (if applicable) and Shipping and Handling added, will be delivered by fax or email. Orders are typically filled in one to six weeks



Payment (US$) should be made by check to:
Term USA
18875 Trillium Lane
Fort Bragg, California 95437
USA

Or by wire transfer of US$ to the account of:
Term USA (account #01295-01820) in
Bank of America (aba bank routing #026-009-593)

Home | Pricing | Order | Request a Quote | Research | Contact