Parts Order Form

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Parts Order Form

Please fill out all fields for expedient delivery. All parts information is provided in manual.
NOTE:

"Unit Price" reflects the price of Quantity:1 of a part in your "Mechanical Parts List" and not a complete set of parts. Example: Ordering Quantity:1 of Part No: 63200P10 Spring (Smallest) will get you ONE spring and not five. If you would like a quantity of five please specify "5" in the "Quantity" space.
Name*

First NameLast Name

Parts Information

	Robot Model	Quantity	Part No.	Part Name	Unit Price	Dollar Amount (Unit Price x Quantity)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

Parts Total (Add All Dollar Amounts) *
Shipping Options

Select one:
Standard Domestic Shipping USPS (5-7 business days)

$6.00
PRIORITY Shipping USPS (2-3 Business Days; Domestic Only)

$11.00
International USPS (Transit Time Varies)

$25.00
Sales Tax Calculation (CA ONLY)
Do you reside in the state of California? *

No (Skip Tax Calculation)Yes (proceed to sales tax calculation below)
CA SALES TAX: CA 10.75% ON PARTS (PARTS TOTAL AMOUNT x 0.1075)
Payment Method (select one)

VisaMastercard

Total Due*

USDTotal Due: (Parts Total + Shipping + tax (if applicable). Total amount subject to notice and cancellation if your calculation is incorrect.

Use your mouse (if on a computer) or finger (touch screens only) to draw in the signature box below
Signature*
Email Address*
Phone Number*

Area CodePhone Number
Ship to (if different)

First NameLast Name
Shipping Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Should be Empty: