Wikco.com Inc. - Order Form

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

Also click on the above link to access our secure credit card payment form if you previously submitted your order and now need to pay by credit card.

If you have not filled out our order form however, then please fill it out first and click submit, and you will then be taken to the link to our payment page so you can complete your order.

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 - The following applies to truck shipments only: If you don't have a way to unload your shipment, then add $75.00 to the shipping for lift gate service. If this is a residential shipment add $50.00 to shipping cost unless the price indicates delivery to all locations. We will contact you if we have any questions and get your approval for any changes.
Type In Shipping Here Plus Any Extra Charges As Listed Above:

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

In the Special Instructions Box below, please indicate you have requested lift gate service.

Shipping charges shown on each page 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

Click The Submit Button Below To Send Your Order To Us.

You will be send to our confirmation page where you can access our secure credit card payment page if you want to pay by credit card.

If you need to print a copy of this form for your records, or to mail us payment by check with this form, then click on the link below first and print this form, then click the submit button below.

Click Here To Expand This Page For Printing


Click On SUBMIT Above To Transmit Your Order

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