HealthCheckSystems

Billing Address
(As shown on your credit card statement.)
First name * Last name * Company Name Address * Address2 City State\Province: * Zip/Postal Code * Country * Day Phone * Cell Phone Fax Email *
Shipping Address
First name * Last name * Company Name Address * Address2 City * State\Province * Zip/Postal Code * Country * Day Phone * Cell Phone Fax
Payment Info
Name on card * Credit Card number * CVV *

Month *(12) Year*(2025)

Visa MasterCard Amex Discover

Quantity	Name		Price EA	Total

1	Lipper International Child's Desk W/chalkboard Top & Chair - Pecan SKU: 554P In Stock - Ships within 24 hours		$120.00	$120.00

1	Peg Perego - Book Pop Up Car Seat Adapter For 2 Single 435 SKU: IKCS0013NA Out of Stock		$39.99	$39.99

1	Naturepedic MC24 no-compromise™ organic cotton lightweight Classic Seamless - White SKU: MC24 In Stock - Ships within 24 hours		$259.00	$259.00

1	Adaptive Star Endeavour 3 - Aed3R Indoor/Outdoor Mobility Push Chair, Red/Black SKU: AED3R In Stock - Ships within 24 hours		$2,636.99	$2,636.99

		Ground, UPS	$53.00	$53.00


			Total	$3,108.98