837 West Main Street ~ Lansdale, PA 19446
(215) 855-1268 ~ (215) 368-0770 ~ FAX:(215) 855-3976
ORDER FORM
Print out this form and use it to fill in the items that you'd like to order
as you look through our site.
837 West Main Street ~ Lansdale, PA 19446
(215) 855-1268 ~ (215) 368-0770 ~ FAX:(215) 855-3976
ORDER FORM
Print out this form and use it to fill in the items that you'd
like to order
as you look through our site.
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ADDRESS |
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CITY |
STATE |
ZIP |
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PHONE |
E-MAIL ADDRESS |
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QTY |
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P/N |
DESCRIPTION |
PRICE |
TOTAL |
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SUB TOTAL |
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PENNA RESIDENTS ADD 6% TAX |
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GRAND TOTAL |
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Please circle your choices: It is best to ship heavy items UPS.
SHIPPING: UPS
POSTAL
PVHC CHOICE
OK TO BACK ORDER: YES NO
SEND REFUND:
YES
NO
VISA MASTERCARD
DISCOVER
CARD # ___________________________ EXP. DATE _________
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ALL ITEMS SUBJECT TO AVAILABILITY AT TIME OF ORDER
PRICES SUBJECT TO CHANGE WITHOUT NOTICE