GreenSense ORDER FORM

ITEM # ITEM NAME    OPTIONS              PRICE QUANTITY     COST

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_______________________________SUBTOTAL FROM PAGE 2: $____________

_______________________________________________TOTAL $____________

VERMONT RESIDENTS ADD 6% SALES TAX $__________
VERMONT RESIDENTS SHIPPING TO ONE
OF THESE TOWNS: Burlington, Dover,
Killington,Manchester, Middlebury,
Rutland Town, S. Burlington, 
Stratton, Winhall, Wilmington, 
Williston. PLEASE ADD 1% 
           LOCAL OPTION SALES TAX $__________ 
                                                (Please NOTE:    )
                                                (For other       )
U.S. Shipping-   TOTAL X .1 =     $__________   (destinations,   )
                                                (we will call or )
Canada Shipping-   TOTAL X .25 =  $__________   (email you       ) 
                                                (before we ship. )
                       TOTAL DUE: $__________

Payment? Please check one: 

Check/Money Order (enclosed)__ PayPal Invoice__

Note: If you choose Paypal, we'll send you an invoice from Paypal via email.

Name_____________________________________  


Address:

Name____________________________Company_____________________________

Street_________________________ City___________________State________

Province_______________ Postal/Zip Code___________ Country__________

Phone___________________ E-Mail Address_____________________________


Shipping Address (If different):

Name__________________________Company______________________________

Street________________________ City___________________State_________

Province______________ Postal/Zip Code____________ Country__________


If you're paying by check, please make your check payable to
GreenSense, and send it to:

GreenSense		(For questions, or to  )
31 Green Acres Drive	(place an order, please)
Burlington, VT 05401    (call 802-860-1299.    )

COMMENTS:					



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Copyright 1998 Alan Wagener