1059 Main Avenue, Clifton, NJ 07011

MAIL ORDER FORM
----------------------------------------------------------------------

Mail or Fax Orders: (973) 272-1073,
24 hours a day, 7 days a week.
PLEASE PRINT THIS FORM IN ORDER TO MAIL OR FAX YOUR ORDER.

SHIPPING ADDRESS:
Name: ............................................................
Address: .........................................................
City :................................................................
State: ..........................Zip...............................
Phone: (............)....................- .......................

 CREDIT CARD HOLDER'S ADDRESS
(if different from left):
Name: ............................................................
Address: ........................................................
City: ................................................................
State: ................................ Zip .......................
E-MAIL (Required):

 

 QUANTITY

 DESCRIPTION

UNIT PRICE
 TOTAL
   Electric Generator Kit (Wooden Generator)  $28.00  
   Electro Magnet Science Set (Kit)  $25.00  
   Magnet Levitation Set  $25.00  
   Electricity and Conductivity Science Set  $25.00  
   Make Electricity Science Kit  $28.00  
   Finger Print Kit (Basic)  $7.00  
   Finger Print Kit (Advanced)  $12.00  
   Starch Test Kit  $25.00  
   Bacteria Growth Kit  $25.00  
   Battery Life Test Kit  $12.00  
   Floating Rings Science Kit  $12.00  
   Crystal Radio   $12.00  
   Electric Motor  $15.00  
   Electric Bell  $12.00  
   
       

 METHOD OF PAYMENT:
Cash (US dollars only)
(We do not accept checks. Add $2 processing fee if you pay by Money Order)

 Visa  MasterCard Amex Discover

ACCOUNT NUMBER:
                                 
EXPIRATION DATE:
           

  -  

           

Charges in your statement may appear as MiniScience
Allow 3 to 4 weeks for standard delivery.

SIGNATURE...................................................................
PRINT NAME .................................................................

 6% NJ Sales Tax for NJ residents only

SHIPPING
$7.00

7 to 10 days delivery

 TOTAL CHARGES
For all other products
listed in our website,
 attach a list.

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