CuisinShop.com<br>Printable Order Form

CuisinShop.com Cuisinart Dealer
89 Long Branch Ave - Long Branch, NJ 07740 Voice Mail 800-303-0551 - FAX 801-730-3937
Print this form and mail or FAX it to us.

Please do not order items that are not listed as "In Stock" on our web site or delivery may take 4-6 weeks or more. In stock items normally ship within 2 business days. We do not sell parts or items that are not listed on our web site. We do not accept payment by check or money order.

(A) Ship To: (name and address)	(B) Bill To: (if different from Ship To)
Name: _________________________	Name: _____________________
Address: _______________________	E-mail: _____________________
Address:_______________________	Address: ___________________
City:_________ State:___ Zip:______	Address: ___________________
Telephone:_____________________	City:________ State:___ Zip:____
	Daytime Telephone:____________

Item #:	Item Name:	Quantity:	Price per Item:	Total:
_______	_________________________	______	___________	_________
_______	__________________________	______	___________	_________
_______	_________________________	______	___________	_________

(D) Totals & Shipping:

purchase amount:	shipping:
up to $20.00	add $4.00	Merchandise Total:________
$20.01-$60.00	add $6.00
$60.01-$100.00	add $8.00	UPS GROUND Shipping (see chart):________
$100.01-$150.00	add $10.00	UPS can not ship to Post Office Boxes
$150.01-$200.00	add $12.00	We are sorry, we can not ship outside the US.
$200.01-$300.00	add $18.00	Alaska & Hawaii please call for UPS 2nd Day Air Rates
$300.01-$600.00	add $22.00
over $600.01	add $30.00	TOTAL:_______

(E) Method of Payment:

___ American Express ___ Mastercard ___ Visa

Credit card #____________________________ & exp. date:____________

CuisinShop.com is an independent Cuisinart dealer.

All product images are copyrighted works of Cuisinart, used by CuisinShop.com with permission from Cuisinart. May not be copied or used without permission of Cuisinart.

CuisinShop.com FAX Order Line 801-730-3937 (orders only)