japanlife_Logo.gif (6274 bytes)      HIGH TECHNOLOGY SLEEPING SYSTEM
           高科技健康睡眠系統

 

Order Form
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Code Product Name Unit Price Qty Extended
Subtotal
California Residents Must Add Sales Tax (8.25%)
Shipping and Handling (see chart below)
Total

 

Shipping Rate (Inland) Shipping Rate(HI &AK)
Ground
Next day
$0.70 per lb. with $4.00 minimum
$1.50 per lb. with $12.00 minimum
2nd Day
Next day
$14.00 for 1st lb. pius$1.75 each add 1 lb.
$14.00 for 1st lb. pius$3.00 each add 1 lb.
Double size pads: $65 minium
Queen size pads: $68  minium
For double and queen size pads: (2nd day)
Oahu and AK:$100.00              Other Islandx:$120.00

 

Remarks



First Name
Middle Name
Last Name
Address
City State
Country Zip
Tel.
Fax

 

Payment Method

* Credit card orders

Card Type:
Card Number:
Expiration Date (month/year):
Name on Card:


* Phone/Fax orders, please call:

    Phone: (408)564-4909; (408)313-1822
    FAX: (408)564-4911


Your e-mail address:

When receiving e-mail, I prefer it to be in:
English
Chinese

Click "Submit" below to mail out this order form. You should receive a confirmation from us via e-mail (if your e-mail address is provided) within 2 business days,


Airsource Enterprises, Inc.
TEL: (408)564-4909; (408)313-1822
FAX: (408)564-4911   
HH01580A.gif (1311 bytes) EMail: japanlife@airsrc.com
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