Offline Order Form
AluminumSpacers.com Off-line Order Form
Order #___________(if applicable)
| Quantity | Spacer Number | Description | Price Each | Total Price |
|
_____OD x _____ID x _____Long |
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|
_____OD x _____ID x _____Long |
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|
_____OD x _____ID x _____Long |
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_____OD x _____ID x _____Long |
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| Total -- | ||||
Shipping Method: Priority Mail for $10.00______
UPS Ground:_____UPS 2nd Day______UPS Next Day______
Ship to:
Name/Attn:____________________________________________
Company Name________________________________________
Address______________________________________________
Address______________________________________________
City_____________________State_______Postal Code________
Country_________________________
Phone #________________________ (Required outside of USA)
Email_______________________(For email confirmation and tracking information)
Circle Credit Card Type: American Express M/C VISA Discover
Credit Card #__________________________________
Expiration (Month/Yr)_______/________
Verification Number_______(Last 3 digits on the reverse side of card/4 digits on the face of AMEX)
Credit Card Billing Address: (If different from Shippng address)
Name___________________________________(Write 'Same' if same as above)
Company Name_________________________________________
Address_______________________________________________
Address_______________________________________________
City_____________________State_______Postal Code_________
