1297 McD Drive
Dover, DE 19901
Phone:800-338-4018
Fax:    302-734-8394

   

Order Form   Please Copy the Order Form and take notes while  you are visiting our site. Click Back Button to return to previous page.

Please provide the following contact information:

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail
URL

          Enter the date of Order

-- mm/dd/yy

Please provide the following ordering information:

Design#  Style#  Description Color Qty Size Price/ea   Total

Total
BILLING
Purchase Order #

Account Name

Account # 

Please list 3 credit references for new account.

Name

 Telephone # Fax #

SHIPPING
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

Choose one of the following shipping options:

UPS
UPS 2nd Day
Parcel Post
Parcel Post Air
 
    Please call 800-338-4018