product order form
Description |
List Price |
Quantity |
Price |
| Lubricant: 2-pk 8oz Aerosol | $100.00 | $ | |
| Lubricant: 4oz Dropper Bottle | $80.00 | $ | |
| Cleaner: 4oz Cleaner | $15.00 | $ |
| Product Subtotal | $ |
| Shipping & Handling | $8.95 |
| 6% Michigan Sales Tax | $ |
| *15% discount given to previous customers listed in our database | $ |
| *10% discount will be given to new customers not in our database | $ |
| Total Amount of Order | $ |
Dentist's contact information and shipping instructions |
Name: ______________________________________________________________ E-mail address to receive additional information and discounts _____________________________________________________________________ |
Please make checks paypable to:
High Speed Lubricants (HSL)
P.O. Box 235
Lake Leelanau, MI 49653
Toll Free: 888-629-3582
Fax: 231-256-7372
Website: www.highspeedlubricant.com
Contact Email: dlub9@yahoo.com
**Online orders are accepted by using Paypal