ORDER FORM

   Please print and send this form by MAIL
 or 
 FAX    (425 ) 649-0361

BACK to Ordering Instructions

Mail to:
Thermette North America, Inc.
39  151st. Place  NE
Bellevue, Washington USA  98007

 Ship to:

 Name:____________________________________

 Address:__________________________________

 City:      _____________________ State ________

 Country ____________     ZIP/Postal Code _______

  Day Phone        (_____) __________________ 

  Evening Phone  (_____) __________________

 Email Address:______________________________

 

 Ship to different address?

 Name:____________________________________

 Address:__________________________________

 City:      _____________________ State ________

 Country ____________     ZIP/Postal Code _______ 

  Day Phone        (_____) __________________ 

  Evening Phone  (_____) __________________

 Email Address:______________________________

 

   Copper Thermette  - Quantity?_________    Price __________    Subtotal __________

              Amount Enclosed   $ ____________  USD      Check # ________

 or,  please charge  my Visa/Mastercard # ______________________________________________________     Exp Date______  3 digit code (on back of card) ________

US Orders: Please Enclose $92.00 USD 

plus $15.00 S & H for each Thermette ordered 

International Orders please check pricing HERE

Washington State residents please add appropriate sales tax

Please allow 2-3 weeks for shipping!

Many Thanks!