Order Form

Order Form

Paying with check or money order: Print and fill out order form, make check or money order for total amount payable to Medonis Engineering.	Delivery inside the USA: Please add $5.00 shipping and handling. Shipment is by UPS Ground Service unless otherwise specified.
Mail Your Order To: Medonis Engineering 282 SW 105th TERR Portland, OR 97225 Phone (503) 860-1980	Delivery outside the USA: For international orders, please contact us for a quote on shipping costs. Duty, VAT left to the purchaser.
Ship To: Name Address City, State, Zip Phone Number

Product Description	Quantity	Price/ea	Total
	______		______
	______		______
Battery Booster 5, DC-DC converter 5 volt output	______	15.00	______
Battery Booster 12, DC-DC converter 12 volt output	______	18.00	______
Maxwell Head Kit, mechanical only	______	150.00	______
Maxwell Head Kit, complete with servos, servo controller, PC software	______	350.00	______
Mini SSC II, serial servo controller, controls up to 8 servos	______	44.00	______
Mini SSC II cable, connects PC to Mini SSC II	______	6.00	______

Shipping and Handling - Please Add:	______	3.00	______
Order Total:	______		______