Order by Mail or Phone

 

By Mail:

1. read product information under "PRODUCTS / ORDER ONLINE" Tab

2. print this page (for best results, set all margins to ".25" and set orientation as "landscape")

3. fill out requested information

4. mail with check or provide credit card information to:  Great States Products

                                                                             PO Box 13255

                                                                             Charleston, SC  29422-3255

 By Phone: Call us at 800-440-3010.

 

By Fax: Please fill out the following order form (order & credit card information) and fax to 800-440-3010.

 

 

Your Name           __________________________  Tel.No. (_____)_________________

 

eMail Address       __________________________

 

Company Name     __________________________  (If applicable)

 

Street Address     __________________________  (Shipping Address - NOT a PO Box)

 

City                    __________________________

 

State                  _________________

 

Zip Code              _________________

 

This a Residential Address (    ).     This is a Business Address (     ).

  

___________________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________________

 

                                                                                                 SALE

DESCRIPTION                                                           PRICE    QUANTITY     TOTAL 

 

Roof-Be-Clean Blend #1 for Highly Stained Roof, 1-Gallon      $36.70    ________   _________  (Regular $48.95)

 

Roof-Be-Clean Blend #2 for Lightly Stained Roof, 1-Gallon      $36.70    ________   _________  (Regular $48.95)

 

Roof-Be-Clean Blend #3 for Clean Roof Protection, 1-Gallon   $36.70    ________   _________  (Regular $48.95)

 

Roof-Be-Clean Blend #1 & Blend #3 Kit, 1-Gallon each            $66.55    ________   _________  (Regular $88.95)

 

Roof-Be-Clean Blend #1, 2-Gallons                                          $66.55    ________   _________  (Regular $88.95)

 

Roof-Be-Clean Blend #2, 2-Gallons                                          $66.55    ________   _________  (Regular $88.95)

 

Roof-Be-Clean Blend #3, 2-Gallons                                          $66.55    ________   _________  (Regular $88.95)

 

Easy Moss Scraper with Handle                                               $49.95    ________   _________  

 

 

   Shipping Charges  (Enter Using S&H Table Shown Below) ................................  ___________

 

                                                                                                          Sub-Total      ___________

 

   Add Sales Tax (North Carolina shipments only) at 7.25% (of Sub-Total)              ___________

                                                                         

                                                                                                      Order Total       ___________

 

Credit Card Information:

 

       Type of Card: Visa (      ),   Master Card (      ),   Discover (      ),   American Express (      )

 

       Your Full Name as it Appears on the Card  ______________________________

 

       Account Billing Address   ______________________________________

 

       City / State / Zip Code    ______________________________________

 

       Account No. ________________________   Expiration Date  ____________   CVV ______ (Card Security Code)
How to find the security code:  For Visa, MasterCard and Discover, look on the back of your credit card.  In the signature strip there are several numbers, some of which may be part of your credit card number.  The last 3-digits in the signature strip is the CVV card security code.  For American Express cards, the CVV code is a 4-digit code on the front, on the right hand side above your credit card number.

  

Check Information:

 

       Check Number  ______________   Check Date      ______________  Check Amount  ___________

 

          (Please Make Checks Payable to "Great States Products")

 

Shipping & Handling Charges Table:
 

$8.80  +  3.25 per Gallon of Roof-Be-Clean®   (i.e., $12.05 for 1-gallon, $15.30 for 2-gallons, etc.) 

          +  4.10 per Easy Moss Scraper®

 

 

 

 

 

 © 2003-2015 Great States Products LLC