(Suggestion: you can print this page to use as an order form.)
Please send us the following information:
Name:__________________________________________________________
Address:_________________________________________________________
City:___________________________________State:_________Zip:________
Country (if not
U.S.):_______________________________________________
Phone (we will call only if we have delivery questions):
(______)_____________
Food Pyramid for Healthy Eating
with Kidney Disease - Pads of 25 color sheets:
| Number of pads |
English Pads,
Cost each, $ |
Spanish Pads, Cost
each, $ |
| 1-4 |
7.95 |
7.95 |
| 5+ (16% discount) |
6.68 |
6.68 |
Shipping Costs:
| Total Number of pads |
Priority
Mail Shipping, $ |
Total Number of pads |
Priority
Mail Shipping, $ |
| 1 |
4.40 |
6 |
10.25 |
| 2 |
6.85 |
7 |
10.85 |
| 3 |
7.85 |
8 |
11.35 |
| 4 |
8.55 |
9 |
12.15 |
| 5 |
9.45 |
10 |
12.95 |
Totals:
| Item |
Quantity |
Price |
Subtotal |
| English Pads |
_____________ x |
___________ = |
__________ |
| Spanish Pads |
_____________ x |
___________ = |
__________ |
|
|
|
__________ (Pad Total $) |
| CA Sales Tax 8.75% |
if shipping to California |
= Pad Total
x .075 |
__________ (Sales
tax - calculate) |
|
|
|
__________ (shipping
- see above) |
| Special Shipping |
(see notes below) |
|
__________ (Special Shipping) |
| Canada - add $4.00 |
Other International add |
$9.00 |
__________ (Grand total) |
Send your order information above plus a check or money order payable
in US dollars to
"Culinary Kidney Cooks" for the amount indicated to:
Culinary Kidney Cooks
P.O. Box 468
Huntington Beach, California 92648
or you may fax this mail order form (if using a credit card
below) to 714-842-4694.
If paying by credit card, please circle one: Mastercard Visa American Express
Discover
Card number: ______________________________Exp. date (mm/yy):
___/___ Signature:________________
Please allow 1 - 2 weeks for delivery of Food Pyramid mail orders. If you
require faster delivery, please consider using our secure Online
order system (with delivery options as fast as 1 day via UPS.)
Click here to return to our
main order page.
Click
here to e-mail us at feedback@culinarykidneycooks.com
if you have any further questions!
