| This online order form is provided to help simplify and organize orders.
It is NOT connected with any CGI script nor does it provide for
e-commerce. You may print it out
as a preprinted form and fill it in by hand or you may type in the details of your
order. When completed, print two copies, keep one copy for your
records and mail one copy with your payment (cashiers check or money
order) to Hampton Engineering, 10621 N. Portal Ave, Cupertino,
CA 95014 or call (408) 873-1623 with credit
card information. Orders will be processed upon credit card
approval or when payment is received.
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| Qty | Part # | Description | Unit Price | Total |
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Privacy Statement: We use this information ONLY for processing of your order. We will NEVER provide it to any other company or person.
| Amount of ORDER: Please add up all the "Totals" above. Insert that amount in this cell: | |
| Orders placed within the state of California MUST add 8.25% Sales Tax: | |
| Shipping & Handling Costs USA add $20.00 (excluding Alaska & Hawaii) | |
| (Please submit
cashiers check or money order in US funds for this amount) ORDER TOTAL: |
Information About Person Placing this Order:
| Name: | |
| Address: | |
| City: | |
| State & ZIP Code: | Phone # |
| E-mail: | For Confirmation & Questions |
Delivery Address (if different)
| Name: | |
| Address: | |
| City: | |
| State & ZIP Code: | Phone # |
Once you've QUIT your program or CLOSED this window, ALL the information
you've typed will disappear. Make sure that you print two copies first.