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Fax to: 602 272-9353 |
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| Acrylic Designs | ORDER FORM | ||||||
| 2948 N. 30th Ave. | 800-209-4204, 602-272-9683 | ||||||
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Phoenix, AZ 85017 |
Fax: 602 272-9353 | ||||||
| SHIP TO: | BILL TO: (If Different than ship to) | ||||||
| Name: | Name: | ||||||
| Address: | Address: | ||||||
| City: | St. | Zip: | City: | St. | Zip: | ||
| Phone: | Fax: | Phone: | Fax: | ||||
| ORDER INFORMATION: | PO Number: | ||||||
| Qty | Item # | Description | Unit Price | Totals |
| Please check your literature. Note: All measurements are WIDE x TALL. | Sub Total |
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| Add minimum order charge for orders under $35.00. (shipping not included) |
$5.00 |
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Arizona residents add 8.1% sales tax |
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We will calculate shipping charges and call with your total |
Shipping |
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| SHIPPING INFORMATION: (Check One Please) | Total order |
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| [ ] | UPS Ground | [ ] | UPS Three Day Select | [ ] | UPS Second Day | [ ] | UPS Overnight |
| [ ] | Your Fed-ex - Express [ ] Your Fed-ex next day saver Your number ______________ | ||||||
| Rush orders may be charged an additional handling fee. You must call us for a heads up. | |||||||
| SPECIAL INSTRUCTIONS (Please specify any special instructions): |
| PAYMENT INFORMATION: | [ ] |
Visa | [ ] |
Master Card | [ ] |
AMEX |
| Cardholder Name: | |
| Credit Card Number: - - - | Expiration: (Month/Year) / |
| Card address | |
| Signature: | |