GlassMask Order Form

  Date   Contact Name   Email Address   Phone Number   P.O.# (optional)

  Company/Mall/Person   Street Address   Suite # (optional)   City   State/Province   Zip/Postal Code

  Company/Mall/Person   Street Address   Suite # (optional)   City   State/Province   Zip/Postal Code   Contact Name   Contact Phone Number

• GlassMask now only sold by the box.
• $180 per box (x4) gallons.
• Only (x1) color per box. No mixing.

• Next Day / 2nd Day Options - will be shipped the day after they are received.
• UPS and FedEx no longer provide 3rd Day Air Freight Service to most locations.
• If you have an Account with UPS or FedEx - please enter it on this Order Form. UPS and FedEx will not divulge your discounted rate to us.

Select one of these Shipping Options...

  Your UPS Account Number (optional)

• UPS Ground delivery time - approximately 5 business days.
• UPS Ground shipping-cost per box - approximately $100.00.
• If you do not provide your UPS Account number - the shipping charges will automatically be applied to your Credit Card.

• If you do not provide your UPS Account number the shipping charges will be automatically applied to your Credit Card.