Please Call or E-Mail inquiries for our Competitive Pricing
PRINT AND FAX ORDER FORM
PLEASE SHIP THE FOLLOWING:
|
Quantity |
Price |
Total |
| ______ MCT 1200 |
____________
|
|
| ______ MCT 2400 |
____________
|
|
| ______ MCT 1200 SPECIAL |
____________
|
|
| ______ MCT 2400 SPECIAL |
____________
|
|
| ______ Silica Gel (1½ yr supply) |
____________
|
|
|
SUBTOTAL:
|
______________
|
|
|
+ Sales Tax (if applicable)
|
______________
|
|
|
|
+ Shipping & Handling
|
______________
|
|
TOTAL: |
____________ |
COMPANY NAME________________________________________
ADDRESS_____________________________________
CITY_______________STATE_____________________
ZIP_________________
AUTHORIZED SIGNATURE__________________________________________
Add $50.00 shipping and handling
ADD 8 ¼ sales tax for sales within Texas
Over-night shipping extra
We accept Mastercard, Visa, and American Express
Credit card #_______________________________
Expiration date_____________
FAX TO: 281-331-7577