B. Method of Payment 
& American Express
CHECK Enclosed . COD USA ONLY. Company Check / Cashier's Check.
Please make checks payable to Palisades Research.
VISA/MC/AMEX#____________________________________ exp. ________
C. Choose Items
- Please refer to Item pages to check your compatibility before placing an order! Also, please read the
Palisades Research Guarantee and Return Policy.
| Description of Items | Quantity | Price |
|---|---|---|
| 1._________________________________ | ________ | __________ |
| 2._________________________________ | ________ | __________ |
| 3._________________________________ | ________ | __________ |
| 4._________________________________ | ________ | __________ |
| 5._________________________________ | ________ | __________ |
| 6._________________________________ | ________ | __________ |
| Subtotal | $__________ | |
| Shipping (see Order Info Page) | $__________ | |
| Tax (CA Only) | $__________ | |
| Total | $__________ |
Print this form and FAX or MAIL to us. Or, give us a call.
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