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