ORDER FORMVITASPACE.COM

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VITASPACE ORDER FORM:

This order page is in the process of being upgraded to a more secure connection. Therefore, the SUBMIT ONLINE ORDER button has been removed but will return in a few weeks. During this time, you may still order via email, phone, fax or postal mail.   You may print this form and fax or mail it to Vitaspace. If you would like to place an order or if you have a question or need a price quote, send an email to peter@vitaspace.com   or call 631-342-1883 or fax 631-342-1903 

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VITASPACE

130 SPORTSMEN STREET

CENTRAL ISLIP, NEW YORK 11722

FAX:631-342-1903    PHONE: 631-342-1883  email: peter@vitaspace.com

YOU MAY PAY BY VISA, MASTERCARD, DISCOVER, CHECK or MONEY ORDER (US Dollars), wire transfer or e-GOLD. 

ORDERS MAY BE  FAXED, PHONED, EMAILED OR POSTAL MAILED TO VITASPACE.   

 

 Please note that your email address is required for us to contact you. For international orders (outside the USA), there will be an extra shipping charge.   Send an email to peter@vitaspace.com  for price quotes.

Payment Method VISA   MASTERCARD   Mailing check/money order  e-gold
Name
Company name (optional)
Shipping Address
City
State/Province
Zip/Postal Code
Country
email address required

For VISA and MasterCard payments, complete the following.

Credit Card Number
Expiration Date
Name on credit card
Billing address of cardholder (address to which credit card statements are mailed) CHECK THIS BOX IF BILLING ADDRES IS THE SAME AS SHIPPING ADDRESS ABOVE.

Date of  order
Phone number (optional)
FAX number (optional)
Purchase Order  number (optional)

Items ordered:

DESCRIPTION                                                 QUANTITY  UNIT PRICE  TOTAL PRICE

                                                                          SUBTOTAL    

  SHIPPING ( = $6.00 FOR ANY ORDER UNDER 25 KG WITHIN THE USA)

  EXTRA SHIPPING for international orders or for orders over 25 kg     

                                                                                TOTAL    

You may type comments or questions in the scrolling text box below. Note that the SUBMIT FORM BUTTON will return in a few weeks after the security upgrade is complete.