CrispyClean® Order Form   1. Enter name, email address, business name
  (if on credit card) and postal address.
  2. Name and postal address must match what
  is on credit card.
  3. Enter number of Cookers and Twin-Pacs wanted.
  4. Twin-Pacs consist of two Cookers in one carton.
  5. To put a Greeting on the label or get a Cooker 
  Gift-Wrapped click on: Select Greeting/Wrap.
  6. If credit card is registered in Illinois, 7.75% tax
  is applied to SUB-TOTALS, less amount of S&H.
  7. All prices below contain S&H
 Bill to Address #1, below:  Date:
 Name
 email
 Business
 Street
 City
 State
 Zip  
 Ship to Address #2, below: (Check box 
 if same as Address #1, above)  Ship to Address #3, below:
 Name  Name
 email  email
 Business  Business
 Street  Street
 City  City
 State  State
 Zip    Zip  
  Product to be shipped to Address #2:   Product to be shipped to Address #3:
  Unit Price Qty Totals   Unit Price Qty Totals
 Cooker $19.95    Cooker $19.95  
 Gift Wrap 3.50    Gift Wrap 3.50  
 Twin-Pac 32.95    Twin-Pac 32.95  
 Select Greeting/Wrap(note 5)    Select Greeting/Wrap(note 5)  
 SUB-TOTAL:    SUB-TOTAL:  
 Illinois Tax (note 6)    Illinois Tax (note 6)  
 FORM # 1 TOTAL:    FORM # 2 TOTAL:  

  Our policy is to ship within a week of receiving your
  order. You will be notified if it will be shipped later
  than the Ship By date. Products are delivered in the
  continental USA by Priority Mail within 3 days of
  shipment; 4 days to Hawaii, Alaska and Puerto Rico. 
  Foreign orders - additional charge - contact us.

  
Receipt Provided after Payment
GRAND TOTAL:
 
Ship by: 

                                   How to Use this Order Form to Ship to any 2 of 3 Addresses per Order. 

                               First: Always start by filling in Address #1. Then: 
                               (1) If you want to ship product to yourself, click the Check Box. Address #2 then 
                               fills in and looks like Address #1. Select any product shown underneath it. 
                               (2) If you want to ship product to an address other than Address #1, do not click 
                               the Check Box. Fill in Address #2* and select any product shown underneath it. 
                               (3) If you want to ship product to yourself at Address #1 and to Address #3*, click 
                               the Check Box. Fill in Address #3. Select any product shown underneath each. 
                               (4) If you want to ship product to both Address #2* and to Address #3, do not click 
                               the Check Box. Fill in both addresses and select any product shown under each. 

                                              *(This address could be your address at another location.)

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