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FAX ORDER FORM FOR Fax: 973.772.8606
ITEMS MARKED WITH E-mail: aloris@aloris.com
AN *(ASTERISK)
We make it easy! Call, fax or mail... Purchase Order No. ___________________________________
Contact Name _______________________________________
Use this form as a handy worksheet and then call us at
973.772.1201 or toll free at 877.722.1733 (between 8am Title ________________________________________________
and 4:30 pm EST) with your credit card information (we Telephone Number (_____)_____________________________
accept all major credit cards: American Express, Bill To: (Please print)
MasterCard, VISA and Discover).
Company Name ______________________________________
OR...
Address_____________________________________________
Complete the order form and fax it to us at 973.772.8606
City _____________________ State ______ Zip___________
(24 hours a day).
OR... Ship To: (if different from information above)
Complete the order form and mail it to us at Aloris Tool Company Name ______________________________________
Technology, P.O. Box 1529, Clifton, NJ 07015-1529. Address_____________________________________________
City _____________________ State ______ Zip___________
For fax or mail orders, please check one: Contact Name _______________________________________
Check or Money Order Enclosed Purchase Order No. (if necessary) _______________________
Please ship C.O.D. Shipping Instructions __________________________________
ORDER # DESCRIPTION PRICE EACH QUANTITY TOTAL PRICE
NOTE: Tax and freight charges will be automatically added to your order. SUBTOTAL
TAX
FREIGHT
TOTAL
a y z r
Conditions, terms, and prices are subject to change without notice.
FAX ORDER TO: 973.772.8606
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