Ship to Company?-- (Leave blank if not sending to a Company) First Name ----------- (We always send to your attention) Last Name ----------- Phone ------------------ Cell Phone ----------- NOTE: Enter Shipping Information BEFORE Selecting a Model Below, as Prices are different Worldwide. Shipping Address -- Town ------------------ State/Province ------ Postal Code -------- (Correct Zip or Postal Code is vital. If none in your area indicate "None") *Country ------------ *Required Ordering Model # -- Select a Model MW1 MW2 MK3 MAC MK4 M200 M400 MG3 T154 T304 S154 AC12 IM20 IM30 DO NOT Select a Model UNTIL listing your Shipping Information above, as the price will not enter correctly. Quantity Product Price Delivered (US) $ NOTE: If the Price does not seem correct press Then FIRST fill in your Shipping Address, Town and Country. SECOND Select a Model, and if the Price is still not correct send your order anyway, as we will always contact you with the Correct Price Before we ship. We accept Master Card, Visa, Discover & Amex Credit Cards Credit Card # ------------ We never charge your card until shipping your order. Expiration Date --------- Card Verification # ----- What is it? Are Credit Card Statements Sent to the address we are shipping? Yes or No -- Use the line below for the address your Credit Card Statements are sent if different from the Shipping Address: -- The following items are Optional for MightyKool Models Only: **(NOTE: Free Shipping/Handling if the Option is shipped with the original order.) Part # C - Optional AC/DC Power -- Qty-- AC/DC Convertor for all MightyKool Models **$29.00 Part # B - Optional 2 1/2 Gal. Kit --- Qty-- Water Container Kit only used with the MW1** $12.00 Part # P - Custom Cooling Pad Set - Qty-- Cooling Pad Set of 2 for all MightyKool Models **$12.00 Part # F2 - Flex Hose 2 Hose Type - Qty--- Flex Hose FH2 For all MightyKool Models **$57.00 Part # F4 - Flex Hose 4 Hose Type - Qty--- Flex Hose FH4 For all MightyKool Models **$137.00 The Single Cooling Pad should be changed after 200 to 300 hours of use in your MightyKool to provide maximum cooling. **(NOTE: If ordering any of the options after the Original Order there will be a Shipping and Handling charge) Grand Total Authorized (US) -- $ This price includes Shipping & Handling. As mentioned if the Price does not seem correct Send anyway as we will contact you with the correct pricing before shipping. *E-Mail Address -----*Required --------