Kal-Care

905 E. Highway 33

Crete, NE 68333

Phone (402) 826-4278  Fax (402) 826-4288

www.kal-kare.com

MAIL / FAX

ORDER FORM

 

Order by: (billing address)

 

Name

Ship To:

 

Name

 

Address

 

Address

 

City, ST Zip Code

 

City, ST Zip Code

 

Phone

 

Phone

 

Email Address

 

 

Method of Payment

Credit Card Number

Exp. Date

Signature Required for Credit Card Purchases

____MasterCard

____Visa

____American Express

____Discover

____Check/Money Order

 

 

 

CVV2

 

 

QTY

Prod # / SKU

DESCRIPTION

UNIT PRICE

TOTAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Shipping Fees

 

Standard Shipping Method   Shipping Method for:
continental US only  

2nd Day Air, Canada & PR

 amount

Shipping

 

For Order of

 

up to $5.00

 $4.50

 

up to $13.70

$18.90

$5.01 & above

$6.95

 

up to $43.70

$26.39

P.O. Box, APO/FPO, AK, HI, & US Territories

 

up to $73.70

$33.63

 

 Amount

Shipping

 

up to $113.70

$40.62
up to $50.00 $6.95   and Above $47.11
$51 - $100 $9.95      
$101 - $150 $12.95      
$151 - $200 $15.95      

 $201 & above

$21.95

 

 

 

 

SUBTOTAL

 

SALES TAX

NE Residence add 5.5%

 

SHIPPING (chart to left)

 

Total

 

If you are not providing a physical address for shipping please make sure you select the appropriate shipping method. The Standard Shipping Method will not apply. We reserve the right to adjust incorrectly selected shipping methods.