How To Order:
Click here to use our on-line order form !
Be sure to include: Your name, as it appears on your credit card ,Mailing Address, phone # , Credit card number and expiration date, Item code number, Quantity, Item Description, price and total price. Shipping costs will be added to the order, based on the chart at the bottom of this page.
OR
Print this order form and mail to:
Der Dienst
P.O. Box 221 /W
Lowell, Michigan 49331 U.S.A.
Order our 20 page Full color Color Catalog #A-6 for just $5.0, the cost of the catalog will be refunded with your first purchase !
| Code No. | Quantity | Item | Price | Total |
| A-6 | One | Color Catalog $5.00 | $5.00 | |
| Item Total | ||||
| Today's Date ____________ | Sales Tax (where applicable) | |||
| Please check if new address | Shipping (see below) | |||
| Promotion code: We will calculate your discount ! | Total | |||
Method of Payment:
| Cash | Check | Money Order | Visa | Master Card |
Name:______________________________
Card Number:________________________
Expiration Date:_______________________
SHIP TO:
Name__________________________________________________
Address________________________________________________
Address 2________________________________________________
City_________________________State______Zip______________
Country________________________________________________
| U.S. SHIPPING & HANDING (Canada & Mexico : add 50% Other Countries :Double rates below | ||
| Item total over $40.00 | $5.00 | |
| Item total $30.00 to $40.00 | $4.50 | |
| Item total $20.00 to $30.00 | $4.00 | |
| Item total $10.00 to $20.00 | $3.50 | |
| Item total $10.00 and less | $3.00 | |