SECURED ORDER PAGE 
 
DUE TO SYSTEM UPDATE YOU CANNOT PLACE YOUR ORDER USING THIS PAGE, BUT YOU NEED TO CLICK HERE TO CONTACT US
This secured order page guarantees that your personal information will be safeguarded.
Please fill out this Order Form and click the Submit button at the bottom of this page.
 
 
 
SpiritKing        for $345.95 + Free Shipping        Quantity  
 
Want it faster? Get the Expedited Processing for $365.95  
 
 
 
PureStill     for  $179.95  with Free shipping          Quantity  
 
Want it faster? Get the Expedited Processing for $189.95  
 
 
 
PureStill Deluxe     for  $199.95  with Free shipping          Quantity  
 
Want it faster? Get the Expedited Processing for $219.95  
 
 

 

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Information about You as the Purchaser (shipping address may be different if wanted as shown on the next page)

Billing address

First name                          Last name

Street address            City

State                   ZIP

Telephone with area code            email (must have to receive confirmation)

 

Shipping address (leave blank if the same as the billing address)

First name    Last name

Street address       City

State                   ZIP

Telephone with area code    email

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Payment information choose one below

 
Bank Name:    
Bank Address: (state only)              

Routing umber: (must be 9 digits)                  

Account number:                             

Confirm Account number:                

Check number: (upper right corner)                   

 

  • Option Two: Fax us your order: 1. fill out the order form above using either your check, credit or debit card

                                2. print out the form            3. fax it to us at 203-741-1040    (24/7, anytime)

 

  • Option Three: Mail us your money order:

    Send your money order to: OMEGASTORES
                                            314 Main St  #4572
                                            Wallingford, CT 06492

 

 

(CLICK  the Submit button, then please wait a few seconds for the page to upload)