Print this form and mail in an envelope along with a US check or money order to the address below:
CHIGG-AWAY ORDER FORM
(Sorry, no international Orders at this time)
NAME_______________________________________________________
ADDRESS____________________________________________________
CITY________________________________________________________
STATE______________________________________________________
ZIP_________________________________________________________
PHONE NUMBER______________________________________________
ITEM
QUANTITY UNIT PRICE
Chigg-Away __________ $5.50
SHIPPING & HANDLING
TIER
1-2 bts
$4.60
3-4 bts
$6.90
5-6 bts
$8.30
Over 6 bts,
Shipped UPS Ground
TOTAL AMOUNT OF CHECK: $_________
MAKE CHECK PAYABLE TO:
Pierson Labs, Inc.
P.O. Box 157
Saluda, NC 28773
Phone: (828) 749-9813
Fax: (828) 749-9249
e-mail- piersonlabs@cytechcis.net
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