EnCor Biotechnology Order Form

Order Form for Purchase Orders: Print this out, fill it in and mail or fax to us. Alternately fill in the form and press the "submit" button at the bottom of the form, which should open your email program, and you can send information 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. Here is the on-line form for credit card orders.

Shipping Address Name:
Institution:
Shipping Address Line1:
Shipping Address Line2:
City:
State, Zip Code or Postal Code:
Country:
Shipping Email:
Shipping Phone:
Purchase Order Number:
Billing Address Name:
Institution or Company:
Billing Address Line 1:
Billing Address Line 2:
State, Zip Code or Postal Code:
Country:
Billing Email:
Billing Phone:
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 print out and 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*.