Order Form


Send or FAX order to:

Geologic Resources
21 Pointe Rok Dr.  
Worcester, MA 01604
USA

Email: 
dhb@geologicresources.com


FAX:     508-329-3342
Phone: 508-425-7291
Toll Free: 877-234-3924 (USA)

 

Shipping Address:

Name:_____________________________________________________________

Company:__________________________________________________________

Address:___________________________________________________________

City, State/Province: ________________________________________________

Postal Code:___________  Country:____________________________________ 

Email Address:______________________________________________________

Phone:____________________________________________________________

Type of Order:       _____ Check/Money Order           _____Credit

Product Description Qty. Price Each Total Amount
       
       
       
       
       
       
       
         
Include shipping amount (From Product Sheet) ........................................................  
State Tax (Massachusetts, USA orders only - 6.25%).....................................................  
   
Total Amount for this order ........................................................................  
Name of Purchaser:
Terms are as follows:   Shipments will not be made until payment has been received in US Dollars and has been accepted by our bank.    Payment can be by credit/debit card, PayPal,  check, or money order.   Checks/money orders should be sent to Geologic Resources, c/o D. Bruehl, 21 Pointe Rok Drive, Worcester, MA 01604, USA.    Payment must include the specified amount for shipping.   We will make adjustments for correct shipping charges, if necessary.   Massachusetts residents are subject to an additional 5% state sales tax.   Checks or money orders should be made payable to "Geologic Resources".    You may print this form which may be mailed or FAXed.    Prices are subject to change without notice.

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