|
Filters-NOW.com 1-877-991-0400 FAX and MAIL Order Form To order by FAX, fill out this form and fax it toll-free to 1-888-823-6475. If ordering by MAIL, fill out this form and send it along with your check or credit card information to: Filters-NOW.com -- 9800 I 65 Service Road North -- Creola, AL 36525 Billing Information: Name: _________________________ Address: _________________________________ Apt/Suite: ________ City: ________________________ State: _____ Zip: ___________ Shipping Information: (If different from above)Name: _________________________ Address: _________________________________ Apt/Suite: ________ City: ________________________ State: _____ Zip: ___________ Contact Information: Daytime Phone: ____________________ Email: _____________________________ Credit Card: Type: ______ Visa ______ MasterCard ______ American Express ______ Discover Card Number: __________________________ Expire Date: (mm/yyyy) ___/_____ Product Information: Item #1: Manufacturer: _______________ (3M, Filters-NOW, Scotch-Brite, Honeywell, etc.) Item: ______________________ (Filtrete 1250, Accumulair Gold, Lens Cleaning Cloth, etc.) Size: ________x ________ x ________ Number of filters: __________ Price per filter: __________ Total Price: __________
Item #2: Manufacturer: _______________ (3M, Filters-NOW, Scotch-Brite, Honeywell, etc.) Item: ______________________ (Filtrete 1250, Accumulair Gold, Lens Cleaning Cloth, etc.) Size: ________x ________ x ________ Number of filters: __________ Price per filter: __________ Total Price: __________
Item #3: Manufacturer: _______________ (3M, Filters-NOW, Scotch-Brite, Honeywell, etc.) Item: ______________________ (Filtrete 1250, Accumulair Gold, Lens Cleaning Cloth, etc.) Size: ________x ________ x ________ Number of filters: __________ Price per filter: __________ Total Price: __________
Order Totals:
If you have questions, please feel free to call toll-free 1-877-991-0400 Comments:
|