Website by:
C & W Webmasters
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Mabank Family Pharmacy
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Please fill out the order form below and you may submit it |
Item # |
Qty. | Amount Each | Amount |
The standard shipping fee for location in the continental U.S. is $10.00.Note: Items will be shipped via UPS ground delivery in the continental U.S. & UPS Overnight shipping is available for an additional charge. International shipping is $10.00 plus the UPS charge. Orders over $100.00 will be shipped FREE UPS ground. |
Merchandise |
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On Items Shipped to Texas Add 8.25% Sales Tax |
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Subtotal |
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Please give complete Street Address. If items need to be re-shipped due to inaccurate shipping information, purchaser is responsible for additional shipping charge. |
Shipping and Handling |
$10.00 | |
TOTAL ENCLOSED |
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*Name:
*Street:
*City:
*State: *Zip Code:
*Day Time Phone:
Evening Phone:
*E-Mail:
*Payment Type:
Card Number
Expiration Date:
Cardholder's Name:
Additional Information:
* Information required to process order
Orders will be confirmed via e-mail as received before the order is shipped