Payment Information Shipping & Handling
| Name: | ________________________________________________________________ | |||
| Address: | ________________________________________________________________ | |||
| Address, Line 2: | ________________________________________________________________ | |||
| City: | _____________________ | State/Prov: | _____________________ | |
| Zip/Postal Code: | _____________________ | Country: __________ | ||
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Telephone: |
_____-_____-__________ |
E-Mail: __________________________________ |
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Quantity |
Item |
Cost Per Item (USD) | Total Cost (USD) | |
| _____ | Splitdorf Voltage Regulator | $135.00 | _______________ | |
| _____ | Autolite GAS Voltage Regulator | $250.00 | _______________ | |
| _____ | Autolite TC Voltage Regulator | $300.00 | _______________ | |
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Select
Payment Method: ____ PayPal ____ Bank Draft ____ Money Order ____ Personal Check |
Merchandise Total: | _______________ | ||
| Shipping & Handling*: | _______________ | |||
| Total Due: | _______________ | |||
| Amount Enclosed: | _______________ | |||
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Select
Preferred Shipping Method:
____ US Postal Service Air Parcel Post ____ UPS (United Parcel Service) |
* Failure to include the correct amount for shipping and handling may delay processing of your order. Please review the shipping information very carefully on the Order Now page of the SplitdorfReg.Com website. | |||
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Please provide shipping detail
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Our privacy policy: your personal information will not be shared with anyone except as required by law.
Payment is accepted in US Dollars only and must include the correct amount for Shipping & Handling (see below).
Orders paid by bank draft, money order or PayPal will ship immediately upon receipt of funds. Personal checks must clear prior to your order being shipped. If you are using PayPal, the following link will take you directly to the GH Mechanical account:
If you have already submitted your payment through PayPal, you can speed up the ordering process if you copy and paste the order form into an e-mail addressed to Orders@SplitdorfReg.com.
IMPORTANT! Make checks, money orders, and bank drafts payable to Gene Harper.
Mail your order form and payment to:
Gene Harper
9350 W. Grandview Ave
Arvada, Colorado 80002
USA
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Shipping
Weights: |
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Splitdorf Regulators: |
$8.00 each U.S. Only, includes postage and insurance. |
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Autolite GAS Regulators: |
$12.00 each, U.S. Only, includes postage and insurance. |
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Autolite TC Regulators: |
$16.00 each, U.S. only, includes postage and insurance. |
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Please indicate your preferred shipping method on your order form. Please include your mailing address when requesting shipping quotes. |
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