Consumer Product Order Form (USA consumers)

Order our products online in our Pest Control Shop! (www.pestcontrolshop.com)

If you prefer to order by mail, please print this form, fill out all appropriate information, and fax or mail* using the contact information at the bottom of this page.  

For export pricing, quantity discounts, dealer or PCO inquiries, or any products not included on the form,  please contact us.

*If you plan to mail in a check with your order, please contact us first for a quote on shipping charges.

Insect Light Traps (ILT's):

Model #

Model #

California delivery addresses, please add appropriate sales tax
(tax rate: __________% ) Amount: _____________________

*Shipping: see below ____________________

C.O.D. $5.00: ____________________

TOTAL _____________________

*Shipping: We typically ship via UPS Ground service, from warehouses in Wisconsin or California, unless otherwise instructed. For smaller items, we may ship Priority Mail. The cost varies based on weight and destination. We calculate the shipping cost and notify you before processing your order.  
Please Note: Items marked * are shipped by truck. 

If you would prefer another shipping method, please indicate here: ________________

Payment Options:

Credit Card Type:  Visa ___  MasterCard___  AMEX ___  Discover ___      Expiration Date _____ / ______

Credit Card Number __________________________________________________

Signature__________________________________________________________

Name on card** (please print)_____________________________________________

** Note: name & address on credit card must match shipping name/address below.

Shipping Instructions - Ship to:

Name___________________________________________________

Company Name___________________________________________________

Address___________________________________________________

___________________________________________________

City____________________________State____________________Zip_______________

Country__________________________________________________

Phone:_______________________Fax:________________________E-mail________________________

Please print this form, fill out all appropriate information, and fax or mail* to us.  
*If you plan to mail in a check with your order, please contact us first (see below) for a quote on shipping charges.

* Our toll-free 800 number is occasionally out of order in some areas; if you can't get through, please call 818-654-9744.

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