INFORMATION NEEDED
THIS IS NOT AN ORDER FORM.
Your Name:
Company:
Address:
Telephone:
Fax:
Email address if you wish to be contacted by this method:
Please write your orders by date wanted and by item!
Putting what you want by the date to be shipped is the most important.
QuantityItem WantedShipment Date
Ship To:
Name:
Address:
Telephone:
Shipment method: US Priority Mail ( )
Federal Express ( ) must have phone #
Message on card: (be brief)
Credit Card:
Expiration:
If you prefer, you may call us with your card information.