Product Order Form

Please read this before placing an order.

Many of our products are of a custom or special nature and are not well suited for on-line ordering. To avoid confusion, we ask that you please call our sales department if you have a complex order. Our sales department can be reached at 800-257-3711 in the US or 610-363-7330 from elsewhere.

  • Fields marked with are required.

  • It is not required that you total your order on this form but please do enter the Price Each. We will mail, fax or e-mail an order confirmation to you upon request.

  • Credit Card charges are entered on the DAY OF SHIPMENT.

You may also read our Privacy Policy.

 

#

Item number

Qty

Description (up to 80 chars)

Price Each

Total

1

 

Finish

 

 
   
  Item number   Description (up to 80 chars) Price Each Total

2

 

Finish

 

 
   
 

Item number

 

Description (up to 80 chars)

Price Each

Total

3

 

Finish

 

 
   
  Item number   Description (up to 80 chars) Price Each Total
4
 

Finish

 

 
   

Subtotal

  Shipping charges are automatically calculated.Click here to see the shipping charge table.  
 

Tax Exempt   You must have a tax exemption form on file with us.

  PA Residents must add 6% sales tax unless you are tax exempt. PA 6% sales tax
  Grand Total
   

Please enter any additional comments or requests here: Maximum of 255 characters.

 

Billing Location

 

Full Name *

 

Company Name

 

Address *

 

Address

 

City *

 

Country *

 

State or Province *
You may leave this blank if not in USA

  Additional:

Postal Zone *

 

Telephone number *

 

Alt. telephone number

 

Fax Number

  Required for fax confirmation.

Your E-mail address *

 

   

Shipping Location

Only needed if different from billing location

Ship to Name:

 

Ship to Company

 

Ship to Address

 

Ship to Address

 

Ship to City

 

Ship to Country

 

Ship to State

  Additional:

Ship to Postal Zone

 

Ship to Telephone number

 

   
   

Credit card type

 

Credit card number *

  You may include dashes for readability.

Expiration Date *

 Enter as MM/YY or MM/YYYY

Name as it appears on credit card *

 

Select order confirmation preference

 

   

Please make sure your order is correct before clicking the Submit button as this will submit your order.

 
 
   

Your credit card information is secure.  Security is provided by VeriSign. For more information, please click on the VeriSign logo.

Also, please know that we do not sell our mailing list.  Your personal information is kept confidential.