EnCor Biotechnology Order Form

Order Form For Credit Card Purchases: You can pay either with a credit card or with a purchase order. Below is the form for credit card purchases. Fill out this form and press the "submit" button at the bottom of the form and your email program should open, and you can send the form from there. Or make a pdf of the filled in form and email it to admin@encorbio.com. You can download a PDF version of this form here. And here is the on-line form for purchase orders.

Name:
Institution or Company:
Address Line 1:
Address Line 2:
City:
State and Zip or Postal Code:
Country:
Email:
Telephone:
Fax:
Credit Card:	Master Card Visa American Express
Credit Card Number:
Expiry Date:

Items requested: Unless otherwise indicated, $200 per aliquot:
Catalogue#: Catalogue#: Catalogue#: Catalogue#: Catalogue#:	number required number required number required number required number required

Shipping options:	Fedex shipping envelope USA and Canada: $18 Fedex shipping envelope international: $36 Fedex in box plus ice packs USA and Canada: $36 Fedex in box plus ice packs internatioal: $60
	or Email or Fax to; EnCor Biotechnology Inc. Suite 40, 4949 SW 41st Boulevard Gainesville Florida 32608 Tel: (352) 372 7022 Fax: (352) 372 7066 Email: *admin@encorbio.com*