OfficeNet
Fax / Phone Order Form
Print and fill out this form and fax or call in your order to one of the following locations:
|
Fremont |
Columbus |
Grand Island |
|
ph (402) 721-6436 ph (800) 658-4441 fax (402) 721-3517 |
ph (402) 564-1309 ph (800) 658-4478 fax (402) 563-1939 |
ph (308) 384-0680 ph (800) 652-9409 fax (308) 384-0681
|
| Ordered by: | Ship To: |
|
Company:__________________________________ Address: __________________________________ Attention of: ________________________________ City: _________________ ST ____ Zip_________ Your Name: ________________________________ Title: _______________________ Date: ________ Phone: ( ) ______________ P.O. # _______ |
Company:__________________________________ Address: __________________________________ City: _________________ ST ____ Zip_________ Your Account # _____________ (we have it if you don't) Special Instructions: _________________________ ___________________________________________ ___________________________________________ |
| QTY | Stock Number | Description | Unit Price | Total Price |