Step =n Go Cycles 

6 Linden Terrace

Burlington, Vermont  05401-4928  U.S.A.

(800) 648-7335

Fax:  (802) 864-6156     

 

To Order:    Please print this form and complete your order.

                           Facilities should use their official purchase order form.

                                    Then simply phone toll free or send by mail or fax.

Date:

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Sold To: Ship To:
Name: Name:

Address:

Address:

City:

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Country:

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Qty

Description

Price Each

Total Price

 

4 Speed Step' n Go Cycle

$1299.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sub-Total Order

 

 

 

 

 

 

Sales Tax – VT residents add 5%

 

 

 

Shipping & Handling for Step 'n Go Cycles

 

 

 

S&H  for Access. & Adaptations not shipped with cycle

 

 

 

TOTAL ORDER

 

 

Method of Payment (U.S. Funds)

(      )  Check Enclosed

 (     )    Visa

(     ) Mastercard

Card #:  __________ - __________ - __________ - __________

Expiry Date: ____/____

Thank You!

 

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