STEP COUNTER ORDER FORM

To Place an Online order for the Step Counters:

( Not-for Profit/Government Agencies (must have a tax-exempt #)

CUSTOMER INFORMATION

Name

Contact Person:
Address (line 1):
Address (line 2):
City:
State:
Zipcode:
Business Phone:
Business Fax:
E-mail:
Tax exempt#:

PAYMENT INFORMATION


Please make checks or money orders payable to:
Florida International University

MAIL PAYMENT TO:
National Policy & Resource Center on Nutrition & Aging
University Park, OE 200
Miami, FL 33199

ORDER INFORMATION

Quantity (Min = 10 pcs.) x $10.00 per counter for orders less than 100 counters

orders over 100 counters $9.50 each

$
Shipping and handling
(see rate chart below)
$
TOTAL
$

Shipping Rates

Quanitity Shipped
Packaging
Shipping & Handling
10-15 units
large priority carton
$12.95
16-39
12x9x3" 2 pc carton
$15.95
40-49
12x9x3" 2 pc carton
$18.95
50-59
12x9x3" 2 pc carton
$22.95
60-69
12x9x3" 2 pc carton
$25.99
70-79
12x9x3" 2 pc carton
$28.95
80-89
12x9x3" 2 pc carton
$31.95
90-99
12x9x3" 2 pc carton(s)
$36.95
100-199
21x12x2" 2 pc carton and/or 12x9x3" 2 pc carton(s)
$41.95
200-299
21x12x2" 2 pc carton and/or 12x9x3" 2 pc carton(s)
$49.95
300-399
21x12x2" 2 pc carton and/or 12x9x3" 2 pc carton(s)
$55.95
400-499
21x12x2" 2 pc carton and/or 12x9x3" 2 pc carton(s)
$61.96

If ordering above 500, different shipping rates will apply. Please contact the Center re these orders.