| How to Order:
1. Fill out our short order form (see below) with your purchase order
2. Attach it an e-mail and send to info@scientificspecialties.biz, or
3. Mail it to our office (see our Contact Information - also below).
Scientific Specialties, Inc. – 5621 South 170th Street – Omaha, NE 68135 – 402.502.4136
www.scientificspecialties.biz
Bill To (if Different)
Name _________________________ Name ______________________
School ________________________ School _____________________
Address _______________________ Address ____________________
City ______ ST _____ ZIP ________ City ______ ST ____ ZIP_______
Phone (____) _____ - ____________ Phone (____) _____ - _________
Fax (____) _______ - _____________ Fax (_____) ______ - _________
Email __________________________
Date ___________________________ Purchase Order # ____________
Quantity Description Price Extension
_______ Microscope Cleaning & Repair_ ________ _______
(Please Include Make & Model)
_______ __________________________ ________ _______
_______ __________________________ ________ _______
_______ __________________________ ________ _______
_______ __Replacement Bulbs_________ ________ _______
Subtotal _______
Tax _______
Parts _______
Total _______
Comments:__________________________________________________________________
___________________________________________________________________________
Please Send Your Order to:
Scientific Specialties, Inc.
5621 South 170th Street
Omaha, NE 68135
info@scientificspecialties.biz
402-502-4136 (Phone/Fax)
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