BIOGENICS - COLOSTROMETER ™

We proudly accept Visa and Mastercard.
Colostrometer™ is a trademark of BIOGENICS - 1980.
© Copyright© 2013 colostrometer.com. All rights resevered.

BIOGENICS
09359 Highway 126
MAPLETON, OREGON 97453 USA
(541) 268-2004
(541) 268-4757 FAX

COLOSTROMETER™ ORDER FORM

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Colostrometer™ with Plastic Shipping/Measuring Cylinder

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**SHIPPING SPECIAL**
Buy two Retail Colostrometers™ and get free shipping (within USA)

DESCRIPTION

QTY

UNIT PRICE

SHIPPING & HANDLING/EACH

Colostrometer™ Only

Colostrometer™ plus Shipping/Measuring Cylinders

Private Label (Free)

Colostrometer™ with Jar

Private Label (Free)

Only Jar

Total Cost

BILLING

* Credit Card:

* Cardholder Name:

* Credit Card Billing Address:

* City:

* State:

* Zip Code:

* Card number:

* Expiration Date (mmyy):

SHIPPING

* Street Address:

Address (continued):

* City:

* State:

* Zip Code:

* Country:

CONTACT INFORMATION:

* Full Name:

Title:

Organization:

Street Address:

Address (continued):

City:

State / Province:

Zip / Postal Code:

Country:

* Work Phone:

Home Phone:

FAX:

* E-Mail:

Website Address:

If you prefer to send your order by FAX, print the completed order form and FAX to:
Biogenics
FAX: (541) 268-4757

If paying by check: print and mail this completed form, along with your check, to: Biogenics
09359 Highway 126
Mapleton, Oregon, 97453 U.S.A.
Telephone: (541) 268-2004

Note: Personal or Business Checks must clear before merchandise ships.