Provide the following information
and mail it with a check or money order to:
(You may also print this form.)
RADON.COM
PO Box 2000
Naples, NC 28760
1-800-AIR-CHEK
Name:_____________________________________________
Address:
___________________________________________
City, State, Zip: ______________________________________
Phone # or e-mail:_______________________________________
(All personal information is kept confidential.)
Number of Kits (limit of 4):_____________ x $9.95 each = $__________
I would like a Long-Term kit for $24.95 = $__________
Grand Total: $___________