Offline Culture Kit General Interest Form (FYI ONLY)

Use this form to send your general Culture Kit interest information. NO PAYMENTS, as this is a general interest only exploration. Pricing information provided, for your information only! When completed, please send form(s) to the following address:

  1. While you are at this site, why not print-out some blank Offline Culture Kit General Interest Forms and provide them to your relatives, friends, neighbors, ..., etc..

    Offline Culture Kit General Interest Data (Information Only):

    Product SKU Description Price $US Qty
    CTR1 Culture Kit $49.95
    Washington State Resident?Yes No

    WA State Residents add 9.5% sales tax
    TBD

    Payment is not necessary at this time, will bill you later.

    Shipping to:

    Name:
    Address:
    City: State: Zipcode:
    Phone: Email:

    Billing Address (if different):

    Name:
    Address:
    City: State: Zipcode:
    Phone: Email:

    Preferred Payment Method:

    Personal Check Cashiers Check Money Order Credit Card

    Privacy note: All information provided will be: used to establish regional levels of interest; used to help establish the Culture Kit product rollout strategy; used to establish an internal marketing strategy; used as future pre-order contact information, and will be privately held and not shared with non order fulfillment entities.

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