FAX/MAIL ORDER FORM
(Please use this form only if you are going to mail or fax your order to us.
We recommend that you print it out and then browse the site.)

MAIL TO:
FAX TO:
PHONE:

INTERLOCK CPT
1336 N. Moorpark Rd. #242
Thousand Oaks, CA 91360

(805) 486-1001
Please Call First
(805) 486-1001
Item Number Description Quantity Price Each Sub Total
         
         
         
         
         
         
         
         
         
Sub Total Only: A  
(see chart below)  Shipping & Handling: B  
 
Sales Tax (California Only): C  
   
(Please add A, B, C) Total  
 

U.S. Shipping and Handling

$0.01-$9.99 $4.00
$10.00-$49.99 $6.00
$50.00-$99.99 $7.50
$100.00-$199.99 $9.00
$200 and Over $10.50
Checks, Money Orders, Or Cashier's Checks
Make Payable to: Interlock-CPT. Checks must be in US Dollars and have full routing numbers at bottom.
Email Address

Shipping Information

  

Full Name:  
Shipping Street Address:
City, State, & Zip:
Phone Number:
 

Thank You!

PLEASE NOTE: “Item(s) will ship within 24 hours of receipt of PayPal Payment, Money Order or Cashiers Check during
a normal business week. For checks, once funds have cleared your order will be processed.”