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Use this Order Form for
Free Delivery and Automatic
Shipment of Filters.
Name
Company
Address
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Name of cardholder
Type of credit card
Credit card number
Expiration date
Authorized signature
Model 301
I would like to receive free delivery of the Particle Filter Kit, twice a year.
Credit Card
By marking this box and signing my name below, I hereby authorize Blueair to bill my credit card for the filter kit
option selected above, twice yearly for the convenience of automatic filter shipments. Blueair will continue to
invoice my credit card until I decide to cancel the automatic shipment in writing. This must be done either by
sending a fax to: (707) 778-2926 or by sending a letter to: Blueair Inc. Foundry Wharf, 625 Second Street,
Suite 202, Petaluma CA 94952, including a signature.