EcoChoices Mail Order Form

(Please use this form only if you are going to mail or fax your order to us. Print, fill out, and mail.)

SEND MAIL ORDERS TO:
EcoPlanet - EcoChoices
P.O. Box 1491
Glendora, CA 91740

Item Number Description Quantity Price Each Sub Total
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Sub Total  (Not including items that require freight quotes, that have heavy/extra large shipping charges, or items with free shipping.): A   ________
(see chart below)  Shipping & Handling For Above Items: B   ________
Sub-total of Other Items: C   ________
Shipping For Other Items (Freight. Quote): D  

________
Miscellaneous: E   ________
Sales Tax (California Only): F   ________
Redeem Gift Certificates:  G   
Certificate #_____________  Name on Certificate______________		 ________
(Please add A, B, C, D, E & F. Then Subtract G.) Total ________

Note:  For Shipments outside the Contiguous United States please Contact Us with the order details for a freight quote.
U.S. Shipping Charges Within Contiguous USA 
(Not for items with extra large/heavy shipping charges, items with free shipping, or items requiring freight quote.)
$0-$30   $5.95
$30.01-$50   $7.95
$50.01-$100:   $9.95
$100.01-$147.99:   $12.95
$148 & up   Free
Checks, Money Orders, Or Cashier's Checks
Please make payable to: EcoPlanet - EcoChoices. Checks must be in US Dollars and be encoded at the bottom of the check. Mail to: EcoPlanet/EcoChoices, PO Box 1491, Glendora, CA 91740
Credit Cards Billing Information (US Orders Only)
 Visa | MasterCard | American Express | Discover
Name as on Credit Card _____________________________
Company _____________________________
Billing Street _____________________________
Billing City, State, & Zip Code _____________________________
Billing Phone Number _____________________________
Credit Card Number _____________________________
Expiration Date _____________________________
CCV - Credit Card Verification Numbers: 
(V/M/D: last 3 or 4 #'s on back of card, 
AE: 4 digits on front)		 _____________________________
Signature _____________________________
Phone number on back of credit card _____________________________
Email Address _____________________________

Shipping Information

   Check Here if Same As Billing Address
Full Name:   _____________________________
Company:   _____________________________
Shipping Street Address:   _____________________________
City, State, & Zip:   _____________________________
Phone Number:   _____________________________
 

Thank You!