Wedge-Ease™ Ergonomic Support Products: Order Form

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Order Form

Please complete this form and press the button at the bottom of the page to send your order to us.

ONCE WE RECEIVE IT, WE'LL CONFIRM RECEIPT AND WILL CONTACT YOU FOR YOUR CREDIT CARD INFORMATION, IF THAT'S THE PAYMENT OPTION YOU CHOOSE.

Place your order by:
EMAIL VIA THE BUTTON ON THE PAGE
FAX: (949) 515-3569
FOR QUESTIONS, CONTACT US AT:
(949) 903-5272 or email candice@wecergonomics.com

Contact Sheet / Order Form

P.O. No.

Date:

Name:

Title:

Company:

Department:

Shipping Street Address:

City: State: ZIP:

Country:

Billing Street Address:

City: State: ZIP:

Country:

Telephone:

Fax:

E-Mail Address:

* SOLD INVIDUALLY, NOT AS A PAIR

Product Description	Item Number	Unit Price	Quantity	Price
MEDICAL/LAB/CLEAN ROOM/GENERAL USE Gray
3 inch wedge, vinyl	W3G	$32.95
2 inch wedge, vinyl	W2G	$30.95
Regular Stacker 1" level	S1RG	$28.95
Mini Stacker level short	S1MG	$26.95
Start-Up Kit: Not sure what to order? Try our Sample Kit, includes one of each size for a quantity of 4. 10% one-time discount. * Does not apply to ESD models.	W4G	$107.82
ESD/CLEAN ROOM Dark Blue
ESD 3" Wedge	W3SD	$39.95
ESD 2" Wedge	W2SD	$36.95
ESD 1" level Stacker	R1SD	$35.95
ESD "Mini" level Stacker	M1SD	$29.95
Start-up Kit *10% one-time discount (One of each, R1SD XL not included)	W4SD	$128.52
ESD 1 Level Stacker Xtra-Wide	R1SD XL	$49.95

Plus sales tax, postage and handling

Method of Payment: Credit Card Check/Money Order

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