Order Sheet
PetMedStore.Com
Fax to 1-866-589-6128
Item Name Quantity Price
     
     
     
     
Sales Tax if order from CA 9.25%  
Preferred Shipping Type Select One
USPS Ground ( 4-5 working days) $5.95  
USPS Priority Mail ( 2-3 working days) $8.50  
USPS Free Ground ( 4-5 working days) order over $100 $0.00  
USPS Priority Mail ( 2-3 working days) order over $100 $4.65  
USPS Express Mail (next day air most cities) $25.00  
International Shipping ( Canada / Mexico) $25.00  
International Shipping ( All Other Countries) $30.00  
Total  
  Shipping Address:
(In CAPITAL LETTERS)
Billing Address:
(If Different)
Name:    
Address:    
City:    
State, Zip Code:    
Phone No:    
Email Address:    
 
Credit Card Type:  
Card Number:  
Expiry Date:    
CVV2 Number for
Visa/ Master card
AMEX
A last 3-digit number in italics
on the back of your credit card
4- Digits from front side of the card
Comment: