ORDER Form
UPDATED 01-09-15

WORD Order Form ~ PDF Order Form ~ or follow instructions below

To order, please follow these 4 easy steps
or call us at 919-563-1600
Please review your order carefully before submitting.
Once your order is submitted, it cannot be changed.
If an order with CUSTOM tuning forks is cancelled, you will be charged for the cost of the CUSTOM forks.

  1. Click this link order@luminanti.com to open a blank email page
  2. Copy and paste the information listed BELOW this yellow box into the blank email created in step 1
  3. Edit the email to answer each item in the list.
  4. Then click "Send" to send the email

We will process your order as soon as we receive it.
Shipping/Insurance (S/I) will be calculated for each order.
We charge the actual UPS or USPS shipping charge.
We only charge a
handling fee for orders paid for via PayPal.

Copy into email and email to order@luminanti.com

ALL the information below MUST BE COMPLETED. If it is not, your order cannot be processed.
Please place an "X" next to an item you are asked to select.

  1. List the items you are ordering and the price:
    (for Gift Certificates, specify "Gift Certificate" and Total Amount)
  2. Name of the person the order is shipping to: ________________________________
  3. Name of the person who is placing the order (if different from above): _______________________
  4. SHIPPING ADDRESS
    Street Line 1:
    Street Line 2:
    City:
    State/Province:
    Zip/Postal Code:
    Country:
  5. Is the shipping address ___RESIDENTIAL ___COMMERCIAL
  6. Daytime phone number of the person who is placing the order: _____________________
  7. Daytime phone number of the person who the order is shipping to (if different from above):
  8. Email address (to send your Receipt and Tracking #): _________________________________
  9. Name on credit/debit card: _________________________________________
  10. BILLING ADDRESS (where your credit/debit card STATEMENT is sent to)
    We MUST have the billing address to process your order. Please "X" one of the following:
    ____ Same as shipping above
    ____ Different Address
    Complete BILLING ADDRESS information below:
      Street Line 1:
    Street Line 2:
    City:
    State/Province:
    Zip/Postal Code:
    Country:
     
  11. ___CREDIT CARD ___DEBIT/CHECK CARD
  12. ___VISA ___MASTERCARD ___AMERICAN EXPRESS ___DISCOVER
    ___
    Diners Club ___BC ___JCB ___Dinacard ___Union Pay
  13. Credit/Debit Number: ________________________________
    Send in one of 3 ways:
    a. Fax to 919-563-1522.
    b. Email the first half of the number in one email and the rest in a second email for security. Email to
    order@luminanti.com.
    c. Call us at 919-563-1600. If no one is available to speak with you, you can leave it on our secure voice mail.
  14. Expiry Date:___________
  15. 3-digit CVV2# (on back of card) OR 4-digit CID# (on front of Am Express card): _____________
    We MUST have the SECURITY CODE to process your order.
  16. Shipping/Insurance (S/I): For USA and Canada orders, we ship Priority Mail or UPS Ground, whichever is less. If you want EXPRESS SHIPPING (extra charge), please note 3-day, 2-day or Next Day with your order. To all other countries, we ship Priority Mail Express International (PMEI). NC Sales Tax of 7.50% is calculated for NC residents who purchase the Golden 'C' Water. We do not express mail the Golden 'C' Water.
  17. Please note any other instructions, comments, or requirements.
    (if you are sending a Gift Certificate, specify the message you'd like to send)

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919.563.1600