Phone (702) 303-3144 or Fax (702) 722-2319
| Model/Stock Number | Item Description | Quantity | Item Cost US$ |
| Subtotal-Add all item costs and enter in the shaded box | Subtotal | ||
| Shipping- Add 20% of Subtotal and enter in the shaded box | Shipping | ||
| Nevada Residents add 7% Sales Tax and enter in the shaded box | Nevada Sales Tax | ||
| Total the three boxes above and enter into the shaded box. | TOTAL |
Shipping Information
If Shipping and billing Address are the same, you may leave
the shipping column blank
| Billing Address | Shipping Address | |
| Name | ||
| Street Address | ||
| Suite/Apartment | ||
| City | ||
| State | ||
| ZIP or Postal Code | ||
| Voice Phone | ||
| Fax | ||
| Email Address |
Billing Information
We accept Check, Postal Money Order, or cash.
We verify all forms of payment prior to shipping merchandise.
| Method of Payment | * |
| By my signature below, I
agree to the Aquatic Dreamscapes Shipping, Payment and Refund Policies,
and I have read and understand these policies as listed on this site. Click here to view our Payment and shipping policy |
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| Signature | * |
| Comments or Special Instructions |
Aquatic Dreamscapes Order Form
This form may be used to order from Aquatic Dreamscapes
Print it out, Fill it in fully and mail with full payment to:
John Hight
1596 Capistrano Ave
Las Vegas, NV 89109
or
PayPal Payments to: sales@aquaticdreamscapes.com