29232 Honeysuckle Knoll
Millsboro, DE 19966
Fax 302-231-8399
Order Form
DATE:
Print this page out for Fax or Mail orders.
|
Order Form
DATE: |
|
Billed To: (Address of credit card owner) |
Ship To: |
|
|
|
|
|
|
|
|
|
|
|
|
|
PHONE NUMBER |
CREDIT CARD # | EXP DATE | CHECK #
|
|
| QUANTITY | PRODUCT NO. | DESCRIPTION | UNIT PRICE | AMOUNT |
| SUBTOTAL SHIPPING & HANDLING TOTAL DUE |
||||
| $5.50 | ||||
Make all checks payable to: Atlascopy, Inc.
THANK YOU FOR YOUR BUSINESS!
http://atlascopy.com