Pebble Peddler.com

Please use this form to place your order.  Once filled out, hit the submit button and the form will be e-mailed to us.  You can also print off the completed form and fax or mail it to us, or send by e-mail by clicking on file, then send, and typing in our e-mail address in the address line.  Once your order is submitted, we will e-mail you back with shipping options and a total.

Payment Methods:  We accept Visa, MasterCard, business and personal checks, money orders, Paypal and Bidpay.  We prefer Paypal as it the quickest, safest, and cheapest method for us.  Since E-mail is not secure, if you want to pay by credit card, either give us a call with the information, send us a message to call you with your phone number and the best time to call, FAX the information to us, or break it up into two or three e-mails and send them separately.  If paying by Charge Card we will need the name as it is written on the card, the card number, and expiration date.  To go directly to PayPal.com, click HERE.

Please provide the following contact information:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail

Please provide the following ordering information:

QTY:	DESCRIPTION Including Specimen Number:	UNIT PRICE:	TOTAL:
	Specimen Total before Shipping:

	SHIPPING ADDRESS (If different from above)
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country