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Mail Order Form

CHECKS OR MONEY ORDERS:

  • Fill out the Form to calculate your cost.
  • Print the Form using the form's "Print" button.
  • Mail the Form and Payment to:

Fran M. Palumbo, LLC
60 Katona Drive, Suite 8
Fairfield, CT 06825

Must be completed
Product
Qty
Unit Price
Total Price
 

SubTotal:

 

Shipping:

Add 6.35% sales tax if you live in

Postage and handling charges:
$12.00 to $25.99.$3.95
$26.00 to $39.99.$6.95
$40.00 to $99.99..$11.95
Over $99.9910.5% of total

Note: for 48 states only (excl. Hawaii and Alaska). Canada, Puerto Rico, and all Int'l orders must be placed by calling customer service. Actual shipping costs will be charged.

CT Sales Tax:

Grand Total:


Must be completed, * indicates required fields.
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* City, State, Zip:

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* E Mail address:

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(Should an error message occur clicking the "Print Order Form" button, use the print button of your browser)



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