Pendemonium's
Secure Order Form



Pendemonium
P.O. Box 447
Fort Madison, Iowa 52627-0447
Phone:   319-372-0881
Fax:   319-372-0882
Email: sam@pendemonium.com
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No Quibble Satisfaction Guarantee

PENDEMONIUM offers a No Quibble Satisfaction Guarantee. We want you to be happy with the items you order! If you are displeased with anything you order from us for any reason, please let us know via email. Upon receipt of your returned item we will issue you a refund less shipping fees. Restored fountain pens carry a one year guarantee on the sac and mechanics. All items must be returned in the condition that they were received.

Pendemonium Privacy Statement:
Our privacy statement is plain and simple. We do not share or sell your name or any other personal information you give us. All customer information remains confidential.



Need Help Ordering?
Click Here for COMPLETE ordering instructions or check our FAQ.



Fill in the items, stock #, quantity, and price of your order here.

Quantity Stock # Description Unit Price Total
Sub Total

If you need to order additional items, please enter in the
comments box at the end of this page.

We will email a confirmation of your order including shipping fees in 24-48 hours. Iowa residents are subject to 6% sales tax.

If you have a special code or coupon number, enter it here:  



 

Please fill in all fields that apply to this order. You must include your email address here - if this is being sent as a gift, enter YOUR email address here! Please double check the email address you enter for accuracy! This is a secure order form, a sender's email is not included in the headers when we receive your order, the email address you enter below is the one we use to confirm your order.
* = Required Field

Ship To:  
*First & Last Name:
Company:
*Address:
Address 2:
*City:
*State/Province: If you are outside the US or Canada,
please select "##" for State/Province.
*Zip/Postal Code:
Country:
*Day Phone:
Eve. Phone:
Fax:
*E-mail:
*Verify E-mail:



IF your billing address for your credit card is different from your ship to address, please fill in the info below.

Bill To:  
First & Last Name:
Company:
Address:
Address 2:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
Fax:
E-mail:



IF this is a gift, please let us know by filling in the info below. Receipts will be mailed to billing address

Gift wrap?     yes    no

Please note: We offer complimentary gift wrap, when
requested, for items over $25. All other items incur a
charge of $5 per gift wrapped item.

Gift Card Message - Please limit to 25 words or less.




Payment Info:  
*Payment Type:
Credit Card # Visa, MasterCard or Discover:

American Express:
Exp Month/Year:    
Security Code: (If illegible, please indicate)
Name on Card:
Note: Name of the person card is issued to,
not bank name!



We will email a confirmation of your order including shipping fees in 24-48 hours. Iowa residents are subject to 6% sales tax.



Enter Comments or Additional Items Here:

Thank you!