Lambert’s Home Services, LLC

www.diywatertesting.com

Please Print and Complete

Name: ____________________________________________________________

Address: __________________________________________________________

City: ___________________________________State:_______Zip:____________

Daytime Phone _____________________________________________________

Email Address _____________________________

Ship to address (if different from above)

Name:_____________________________________________________________

Address:___________________________________________________________

City:____________________________________State:_______Zip:_____________


Method of payment:
[_] Check or money order enclosed: Payable to Lambert’s Home Services, LLC
[_] VISA
[_] MasterCard
[_] Discover

Credit Card Number:__________________________________Exp.Date___________

Your Signature:______________________________________Date:_______________

For Mail-In Orders send to:
Lambert’s Home Services, LLC   -    P. O. BOX 328 Bristol, IN  46507-0328
Order by Fax:     (574) 966-1353
Order by Phone: (574) 596-6124
Order by email: orders@lambertshomeservices.com

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Please add up your order and fill in the amounts below:

Merchandise Subtotal ______________________

Shipping and Handling ___________________

(IN Residents add 6% sales tax)___________

Order Total ____________________________

** 5% applies to orders placed thru our website using a credit card or paypal at time of sale