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If you would prefer to fax your order to us at Preisner Pewter, please complete the form below and fax it to us directly at 508-892-9745. If you prefer to send your order to us, please complete the form below and send it along with payment (check, certified check, or credit card) to us directly at:
Preisner Pewter
P.O. Box 400 1030A Stafford Street Rochdale, MA 01542 |
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PREISNER PEWTER PRINTER FRIENDLY FAX ORDER FORM
FAX TO (508) 892-9745 |
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Name: ___________________________________ Company:_________________________________ Address:__________________________________ City: ____________________________________ State, Zip Code: ____________________________ E-mail: ___________________________________ |
Name: ___________________________________ Company:_________________________________ Address:__________________________________ City: ____________________________________ State, Zip Code: ____________________________ E-mail: ___________________________________ |
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Your Name: _______________________________ Phone: ___________________________________ Date: ____________________________________ P.O. Number: ______________________________ |
For Credit Card Orders, Please fill in the information below. Name On Credit Card: ________________________ Credit Card #: ______________________________ Expiration: _____________CID Code:____________ Signature: _________________________________ |
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Special Shiping Instructions:
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