JAMES RAINHO PRODUCTS - SIMPLEX
MAGIC
14 Windsor Rd. - Medford, MA 02155 - USA
Phone:(781)391-6800 - Fax:(781)391-2282
Email: magicjim@rainho.com
ORDER FORM
FOR STANDARD MAIL ORDERS ONLY - TO BE PAID BY CHECK OR MONEY ORDER
(IN US DOLLAR for International Orders)
| FROM: (CustomerInformation Date:_________________________________ NAME:_____________________________________________ ADDRESS:_________________________________________ CITY:______________________________________________ STATE/PROVINCE:__________________________________ POSTAL CODE:_____________________________________ COUNTRY:_________________________________________ TELEPHONE NUMBER:______________________________ EMAIL:_____________________________________________ |
TO BE SHIPPED TO: NAME:___________________________________________ |
|
ITEMS ORDER ...NO.---/--QTY.-/-----------------------------ITEM
NAME----------------------/- UNIT PR.--/--TOTAL PRODUCTS TOTAL DOLLAR AMOUNT:__________________ - |
FOR
SHIPPING/HANDLING FEES & INSURANCE FEES
CLICK HERE TO GO TO SHIPPING INSTRUCTIONS PAGE.
This applies ONLY to orders to be processed by mail.
PRINT OUT ORDER FORM ABOVE
Fill it in and mail it with check or money order to address above.