Home / Paper / Printers / Gel Doc Systems / Monitors / VCRs / Gel Warmers / Ultrasound Gel / Software & Accessories
Mitsubishi Print Media/Paper
Order Form
(To submit an inquiry only, go to the bottom of this form, enter your inquiry and submit.)
Title
City
Telephone
(click on the type/s/ and quantity of media you would like to purchase)
Mitsubishi Print Media/Paper Quantity of boxes or packs
K-65H K-65HM K-91HG K-61B (same as K-61S) K-70B (same as K-70S) K-75H K-75HM CK-10S CK-30S CK-30L CK-100S CK-100L CK-100P CK-200SA CK-200BS CK-200LB CK-200TS CK-2000BL(U) CK-2000L(U) CK-2000S(U) CK-2000TL(U) CK-700: 1 Case (10 ROLLS) CK-700: 1 ROLL PK-700S: 1 case = 10 packs PK-700S: 1 Pack = 1 Roll PK-700L: 1 Case=10 packs PK-700L: 1 Pack = 1 Roll CK-710SPC CK-710LPC CK-700L4P CK-700S4P CK-700LC CK-700SC CK-714SPC CK-800L CK-800S CK-800FL4P CK-800FS4P CK-8000FL4P(E) CK-8000PSTE CK-8000FX4P CK-8000FW4P CK-8000FM4P CK-900S CK-900L CK-900S4P CK-900L4P CK-900S4P(HX) CK-900L4P(HX) CK-3020L4P CK-3020LL4P CK-3020L4PM CK-3020LL4PM SU3-11C3H SU3-11C4H A-SPW None Selected G37-10C3 G65-11C3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 0
Enter competitor's lower price and place where it can be validated in box below. (NOTE: IF NOTHING IS ENTERED, PRICE OFF OF SCIENTIFIC DIGITAL IMAGING WEB PAGE WILL BE USED)
Mitsubishi Print Media/Paper Quantity of boxes
K-65H K-65HM K-91HG K-61S K-70S K-75H K-75HM CK-10S CK-30S CK-30L CK-100S CK-100L CK-100P CK-200SA CK-200BS CK-200LB CK-200TS CK-2000BL(U) CK-2000L(U) CK-2000S(U) CK-2000TL(U) CK-700: 1 Case (10 ROLLS) CK-700: 1 ROLL PK-700S: 1 case = 10 packs PK-700S: 1 Pack = 1 Roll PK-700L: 1 Case=10 packs PK-700L: 1 Pack = 1 Roll CK-710SPC CK-710LPC CK-700L4P CK-700S4P CK-700LC CK-700SC CK-714SPC CK-800L CK-800S CK-800FL4P CK-800FS4P CK-8000FL4P(E) CK-8000PSTE CK-8000FX4P CK-8000FW4P CK-8000FM4P CK-900S CK-900L CK-900S4P CK-900L4P CK-900S4P(HX) CK-900L4P(HX) CK-3020L4P CK-3020LL4P CK-3020L4PM CK-3020LL4PM SU3-11C3H SU3-11C4H A-SPW None Selected G37-10C3 G65-11C3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 0
Payment Information
Purchase Order Number
OR
Name exactly as it appears on credit card
Address to which credit card bill is sent
Zip Code to which credit card bill is sent
Credit Card Type VISA MasterCard American Express None Selected
Credit Card Number
Expiration Date: Month None Selected 01 02 03 04 05 06 07 08 09 10 11 12 Year None Selected 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Shipping & Handling
Type of Shipping & Handling Requested
Ground (2-5 Business Days depending on your location)
3-Day
2-Day
Standard Next Day (by 3:30pm)
Priority Next Day (by 10:30am)
(If None Selected, order will go by "Ground")
(NOTE: Shipping/Handling charges are billed as the cost charged by shipper. Charges are dependent upon number of boxes and type of paper purchased.)
(NOTE: After clicking submit, we recommend printing off the next page for your records. If you do not receive e-mail confirmation within 2 hours, please call 1-800-239-5657.)