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Kirk News Mail Order Form:

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Contact and billing information:

Name:

 

Street Address:

 

Address 2 (if needed)

 

City, State and Zip:

 

Country

 

E-mail:

 

 Phone: [  ] Day or [  ] Evening

  (         )

Special instructions:



Order information (click here to see an example)

 Product Name and Description

PRICE

QUANTITY

TOTAL

 Prescription Guide To Mexico and Canada  $14.95    
 Prescription Guide To Europe and Canada  $14.95

 Prescription Guide To Mexico, Europe and Canada  $24.95    

(Standard Shipping and Handling for all orders

5.00

Subtotal

 

No additional charges for standard USPS shipping to
All 50 U.S. States and Territories (go to total)

 

Additional Shipping Fee For Express USPS shipping  U.S. 50 States and Territories
(Available only with Money Order)
Add $20.00

 

Additional Shipping and Handling Charge for CANADA ONLY
(U.S. funds only)
Add $1.00

 

(Additional Air Mail Shipping and handling Fee for all Western European  countries)
(U.S
. funds only)
Add $5.00 

 

(Additional Priority Shipping and handling for European countries)
(U.S. funds only) Add $20.00

 
Subtotal

 

TOTAL

 

Please make your check or money order
payable to
Kirk News,
Please send check or money order (U.S. funds only) to:

 
Kirk News
P.O. Box 5748
Wilmington, DE 19808-0748

Instructions: Please print the above form on your printer. With your mouse
HIGHLIGHT
everything above these instructions. Click the FILE option
in the upper left corner of this screen. Go down the options to PRINT
option and click it. When the new window opens, click the SELECTION
button. Then click the OK Button. When the above form prints out,
fill out form as necessary, refer to the example below if necessary, then
send it along with payment to the above address.


Return to the Order Page

 

SAMPLE

Contact and billing information:

Name:

 John Doe

Street Address:

5555 Oak Street

Address 2 (if needed)

Suite 3B

City, State and Zip:

Mountain Town, NY 10433

Country

USA

E-mail:

 john@dot.com

Phone: [ X ] Day or [  ] Evening

   ( 222 ) 222-2222

Special instructions:
 Do not ship Until Monday. I will be back from my business trip then. Thank you.  


Order information

Product Name and Description

PRICE

QUANTITY

TOTAL

 Prescription Guide To Mexico and Canada  $14.95    
 Prescription Guide To Europe and Canada  $14.95

 1

 14.95

 Prescription Guide To Mexico, Europe and Canada  $24.95    

(Standard Shipping and Handling for all orders

 5.00

Subtotal

 19.95

No additional charges for standard USPS shipping to
All 50 U.S. States and Territories (go to total)

 

Additional Shipping Fee For Express USPS shipping  U.S. 50 states and territories (Available only with Money Order) Add $20.00

 

(Additional Shipping and Handling Charge for CANADA ONLY) (U.S. funds only)
A
dd $1.00

 

(Additional Air Mail Shipping and handling Fee for all Western European  countries)
(U.S. funds only)
Add $5.00 

 

(Additional Priority Shipping and handling for European countries)
(U.S. funds only) Add $20.00

 
Subtotal

19.95

TOTAL

19.95

(Back to blank order form)