ORDER
FORM

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www.askalanaquestion.com
Pool and Spa Informational Website
To order by E-Mail or Fax, using a Credit Card.
Check payments will not ship until cleared.
Need Ordering Help?  Call 919 290-3957 (9AM-7PM Eastern Time U.S.)
Aqualab Systems, Inc.
5448 Apex Peakway, #129
Apex, NC 27502
Quantity Item No. Description Unit Price Total
         
         
         
         
         
         
         

You can calculate the total shipping charges, by proceeding to checkout. This does not complete the order. Your order will not be processed, until this form is received by E-Mail or Fax. If the order is outside of the Continental U.S., additional shipping charges may be required. If so, you have the option to cancel the order.
* IF SHIPPING IS LEFT BLANK, YOU WILL BE NOTIFIED OF THE ACTUAL CHARGES, PRIOR TO SHIPMENT, FOR YOUR APPROVAL.

 Sub Total  
Shipping *  
Grand Total  
E-Mail Orders: highlight form and paste in your E-Mail Brower. Fill in all information and send to: askalanaquestion@msn.com
Fax or Mail Orders: print this page and fill out all information. Fax to: 919 367-7866 or mail to the address at the top of page.
Payment by Check Orders: print page and fill in product and address information.  Mail to address at the top of the page.

Billing Address (bold fields are required)

Shipping Address (bold fields are required)
  (    )  Check here is same as billing information
First Name: First Name:
Middle Initial: Middle Initial:
Last Name: Last Name:
Company: Company:
Address: Address:
Apt./Suite/floor:   Apt./Suite/floor:
City: City:
State/Province: State/Province:
Zip or Postal Code: Zip or Postal Code:
Country   Country:
Phone Number: Phone Number:
E-Mail Address:  
Method of Payment: (   ) American Express      (   ) Discover      (   ) Mastercard      ( ) Visa
Name (as it appears on card):
Credit Card Number:
Expiration Date: Month/Year:      /         (Example 05/15)
Verification Number ( 3 digit code on back of card):

***** IMPORTANT - PLEASE READ ******
Any claims of incorrect items, shortages, shipping damage or failure to perform properly. must be reported within 30 days, of the receipt of the merchandise. After 30 days, no refunds will be given and repair and/or replacement will be subject to the manufacturer's warranty policy. Returned goods must be in the original packaging and may be subject to a reasonable restocking charge, if returned within 30 days, after receipt of the merchandise, and will require a return authorization number. Send an e-mail, including relevant information, to: askalanaquestion@msn.com to request a return authorization number. Returns, after 30 days, will not be accepted.

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