D-3AD Undercounter /Glacier 100 Countertop Water Distiller              Purchase Form

Price:   Call for Manufacturer's

Special Discount Pricing 1-866-382-3442
  
           
*(Applicable taxes & Shipping & Handling are extra)
                                           

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To Arrange Payment:
I would like a Glacier representative to contact me for payment information.
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I will contact a Glacier representative by phone/fax to arrange payment.
     Tel.: 905-657-5128 Fax: 905-657-5131 Toll Free: 866-382-3442

Visa & MasterCard accepted.