Order Form

Vita Corp.

No. 1 Birchwood Ln, Hartsdale, NY 10530

Phone: 1-914-217-0049  Fax: 1-914-202-7469

www.vitacorpusa.com    e-mail:  sales@vitacorpusa.com
Sold to: Shipping Address:
Name:
Tel:    
E-mail:  
Requests:
  Qty. Size Description Unit Price Total
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.

Payment Method:   Visa     MasterCard      Discover

Shipping:

Card Holder's Name:

Total:

Card #:   Expire Date:

   

Thank you order with Vita Corp

** ALL CLAIMS MUST BE MADE WITH 7 DAYS AFTER RECEIPT OF MERCHANDISE **

To avoid a 2% late payment charge, your payment must be received by the term date listed above.