Email Order Form

This form page has opened in a separate window,

to make it more convenient to use while browsing our site.

Email Your Order Request:  

  1. Submit an order request using the form below.  Indicate the item number, description, and quantity for each item ordered.     NOTE:  WE CAN ONLY ACCEPT ORDERS THAT ARE SHIPPED WITHIN THE CONTINENTAL UNITED STATES

  2. After you have added the items that you wish to order, use the "submit" button to email your order to us.  We will calculate the total of your order, including shipping & handling.

  3. You will receive an E-Billing which will include the total amount due, and instructions on how to complete your order.  Payment options will appear on the E-Billing.  We accept payments by PayPal, personal check, or money order.

  • Enter Your Shipping Information:

Name:

 

 

Address:  

  

 

City:

State:

Zip:

  • Enter Your Contact Information:

Phone:

  ie: 555-555-5555

E-mail:

    

  • List your selected items:

Item #

Item Name or Descripton

Unit Price

Quantity

  • Enter additional comments or instruction in the box below:

 

PRIVACY STATEMENT:

Personal information requested on this form will not be used for any other purpose than placing an order with us.

And will not be used or exchanged  for any other purpose.

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