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Order Form

This form is for persons that are ready to order products.  Please complete all information accurately but be certain that the contact phone number(s) you provide are correct!

Because of the wide choice of products, options, variables and colors you cannot order directly on-line.  Please fill out the information below accurately being this information is used to process any orders.  Someone will be calling you back promptly to discuss the particulars with you by telephone.  Again, most importanly, be certain to leave a VALID telephone/contact number.  Also any additional information about callback times or information about what you need is also helpful.  Please write any remarks/notes in the “comments box” provided below.

THANK-YOU


Email Address:
Company Name:
First Name:
Last Name:
Address:
City:
State:
Zip:
Country:
Phone: Area Code-
Fax: Area Code-

Yes, I am interested in ordering.
Yes, it is OK to contact me by phone.
Please contact me by telephone 
Call After  PM 
Or  between the hours of  AM &PM
I need products within weeks.
Comment Box: 

 -After you press [send] please wait for the next screen,this may take a minute.-

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