Covert Labs: Orders
Your Info
*
Name:
- Required fields. Please fill out order form completely to ensure a proper order.
*
Billing
address:
- must match address on billing statement for order to be processed*
*
City, State / Zip:
- State -
AK
AL
AR
AZ
CA
CO
CT
DE
DC
FL
GA
HI
IA
IL
ID
IN
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
*
Email
address:
- required for confirmation
*
Shipping
address:
- if different from "Billing address".*
*
City, State / Zip:
- State -
AK
AL
AR
AZ
CA
CO
CT
DE
DC
FL
GA
HI
IA
IL
ID
IN
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
your info
product select
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Product Info
product
single unit price
quantity
auto ship price
subtotal
5.99
0
1
2
3
4
5
6
7
8
9
10
14.95
39.95
0
1
2
3
4
5
6
7
8
9
10
N/A
24.95
0
1
2
3
4
5
6
7
8
9
10
N/A
24.95
0
1
2
3
4
5
6
7
8
9
10
N/A
34.00
0
1
2
3
4
5
6
7
8
9
10
N/A
34.00
0
1
2
3
4
5
6
7
8
9
10
N/A
34.00
0
1
2
3
4
5
6
7
8
9
10
N/A
99.95
0
1
2
3
4
5
6
7
8
9
10
N/A
39.95
0
1
2
3
4
5
6
7
8
9
10
N/A
24.00
0
1
2
3
4
5
6
7
8
9
10
N/A
sales tax:
sales tax for residents in AZ:
Total:
how would you like your items shipped?
1. No selection automatically receives ground $9.00*
2. Shipping may be higher to Alaska and Hawaii.
3. Shipping Amount will be added to the Total showing here.
Ground $9.00
2 day air $15.00
Next day $25.00
Did you sign up for Auto-Ship so you can save $$$?
your info
product select
payment
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Payment Info
*
Credit Card:
Visa
Mastercard
AmEx
Discover
*
Card number:
*
Exp. date/sec code:
1
2
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9
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/
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
3 digit code on the back of card,
must be included!
Phone/Fax:
/
your info
product select
payment
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Monthly-Ship Info
NEW MONTHLY-SHIP PROGRAM
RECIEVE PRODUCTS EVERY MONTH AUTOMATICALLY!!
Save more money by signing up for our auto-ship program.
This program is perfect for those who want to receive a particular product on a monthly basis.
We will bill your credit card every month and send your product to you automatically.
STOP!
If you would like to sign up for auto-ship and agree to the terms above enter initials here
Monthly-Ship Agreement 1. I agree that once every month I will receive and pay for the above selected product(s) and quantities at the price indicated on this website. 2. I agree to have Covert Labs, Inc. debit my credit card once each month for the amount of the product to be shipped as specified in this website. The date that this transaction will occur will be provided in documentation with my first shipment. 3. I understand that auto-shipment will be sent out via UPS ground unless otherwise requested. 4. I understand that in order to cancel my auto-ship obligation, I must provide written notice of my request to cancel 30 days prior to the next agreed upon shipping date. 5. Notice can be sent to: Covert Labs, Inc. P.O. Box 27924 Tempe, AZ 85260 You can also set up your auto ship by faxing your payment and shipping info 480-756-2728.
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Copyright © 2004-
Covert Labs, Inc. All rights reserved.
*No statement on this site or on our products has been evaluated by the FDA.
These products are not intended to diagnose, treat, prevent, or cure any disease.
Revised 04/20/08
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