Acceptable forms of payment

Upon Completion/Submission of this form you will be contacted by Brandstrom Instruments Finance/Administration Manager for your credit card information. Do not include any credit card information on this form.

  • Purchase Order (Terms Net 30)
  • Business Check (drawn on a US bank)
  • ACH, Wire or Paymode-X
  • Major Credit Cards

To initiate a credit card payment:

Contact Information:

Product Information

End Use Description

Is the use military in nature? (Must select one.)


Ship To:

If you do not have a Freight Collect carrier account, Brandstrom Instruments, Inc. will bill shipping/duties/VAT/tax charges to your credit card and provide package tracking reference information and a credit card receipt upon shipment.

*Confirmation: I understand that by checking this box and typing my name & title above, I am signing this document electronically.