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Order Form for Acrylic Practice Blocks for Cerec® Machines
Product # PiBlock
Quantity (please mark one):
10 @ $8.00 each = $80
20 @ $7.00 each = $140
50 @ $6.00 each = $300
100 @ $5.00 each = $500
More than 100; desired quantity
; we will quote.
Email:
Shipping Options (please mark one):
No shipping fee for
prepaid
orders sent via first class mail.
via USPS First Class Mail (usually 2-4 days) $5
via USPS Express Mail (overnight) $15
Payment Options
Product Total:
$0.00
Shipping:
$0.00
Order Total:
$0.00
Prepaid
Invoice
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Click here if Billing and Shipping information are the same
Shipping Information
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Address 2
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Fax
Orders accepted via phone, fax, email, or mail.
Credit cards accepted via PayPal.
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