I hereby certify that the above Information is true and correct, by clicking submit I give my consent to process this order. I understand my order will not be processed until payment is received by UC Premier. All payments must be made by credit card.
Name of Person Submitting Order:
After clicking Submit you will receive an email confirmation with your complete order. Please print a copy of this email for your records. For information on your order or payment questions please direct them to Vince Prasad via email at firstname.lastname@example.org or call (510) 860-3803. Please allow two weeks for merchandise arrival.
NOTE: Clicking Submit more than once will create a duplicate order. Only click Submit when you have fully completed and reviewed your order.