Wikco.com Inc. - Order Form

Click Here To Review Our Payment Options ($7000.00 limit on credit card sales).

Click Here To Expand This To A Full Page Version

Press The "TAB" key or use your mouse to go to each field on the order form - DO NOT HIT THE ENTER KEY (this will send the order).

FIRST NAME:

LAST NAME:

COMPANY NAME:


When paying by credit card WE MUST SHIP TO THE BILLING ADDRESS ON THE CREDIT CARD AND IT CANNOT BE A POST OFFICE BOX. If your billing address is not a physical address, then please pay by check, money order, or wire transfer.

SHIPPING ADDRESS (This Must Be The Credit Card Billing Address When Paying By Credit Card):


CITY:   STATE:   ZIP Code:

PHONE:

E-Mail Address:


ITEMS ORDERED - (Please Include Model Number And Description Of Items)

ITEM 1:

QUANTITY:  AMOUNT:


ITEM 2:

QUANTITY:  AMOUNT:


ITEM 3:

QUANTITY:  AMOUNT:


ITEM 4:

QUANTITY:  AMOUNT:


ITEM 5:

QUANTITY:  AMOUNT:


ITEM 6:

QUANTITY:  AMOUNT:


ITEM 7:

QUANTITY:  AMOUNT:



SUB-TOTAL:

+Sales Tax (AZ residents only - 8.7%):

+SHIPPING - Type In Shipping Here:

=TOTAL CHARGES (total merchandise cost plus shipping charges):

Shipping charges shown are for shipments within the U.S. 48 states only. For shipments to Alaska, Hawaii and Canada and other countries, please e-mail us.

Click Here For information on shipments to Canada and Internationally

TELL US ANY SPECIAL INSTRUCTIONS HERE:


Ordering And Payment Information

To order and pay online, transmit your order to us by clicking the SUBMIT button below. You will then be taken to the confirmation page where you can pay via credit card with our secure payment page.



Click Here To Expand This Page For Printing If You would Like To Fax This Page To Us Or If You Need A Copy For Your Records

If you are faxing your order, manually write your payment information on the form and fax the order form to us toll free at 866-464-8893.

If you are paying by check or money order, then you can mail your order and payment to the address on this form. If you would like to pay by bank wire, please contact us to request our bank information.

If you are paying by check or money order and have a separate mailing address, you can enter it below.

Mailing Address:

City:  State:  Zip Code:

E-Mail:   Phone Number:

To pay by wire transfer, please e-mail us and request our bank information.

Fax Your Order To: 520-316-0446 - 24 hours per day, 7 days per week

Please Note: The Terms Listed Below Apply To Your Purchase