UCCA Order Form

We also accept payment by check or money order.  Orders paid for by check will be shipped after check has cleared.  Orders paid by money order will be shipped within 2 business days.  Please be sure to include your email and phone numbers so we can update you on the status of your order if necessary.

You may print this form to include along with your payment.

Date:_____________

Name:__________________________________________________    Email:___________________________

Street:__________________________________________________     Phone:__________________________

City:_________________________ State:_____  Zip:_____________

Shipping Address:

Name:__________________________________________________

Street:__________________________________________________

City:_________________________ State:_____  Zip:_____________
                                                                                             

Item# Description Qty. Price Total
         
         
         
         
California Residents only add sales tax 7.75%  
Shipping & Handling inside USA ($28.00 per CoachCam)   
Total  

Make out check and mail to:
Underwater Camera Company of America
1488 Pioneer Way Suite 5
El Cajon CA 92020
Phone: 619-997-7946
Fax: 619-590-9254