Printable Order Form

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Printable Order Form

Start-Rite, Inc.

PLEASE PRINT THIS PAGE, FILL OUT ALL APPLICABLE FIELDS AND FAX TO OUR OFFICE AT (631)205-1593:

To print: Click here or Select File and then Print from your browser's menu.

BILLING ADDRESS:

SHIP TO ADDRESS:

COMPANY NAME:

COMPANY NAME:

ADDRESS:

ADDRESS:

ADDRESS 2:

ADDRESS 2:

CITY, ST, ZIP:

CITY, ST, ZIP:

ATTN:

ATTN:

TEL:

FAX:

________ CREDIT CARD

_______ CHECK/M.O.

_______ INVOICE

CC #:__________________________________________ EXPIRATION DATE:____________

ITEM #

DESCRIPTION

QUANTITY

UNIT PRICE

TOTAL

TOTAL CASE QUANTITIES

TOTAL KIT QUANTITIES

Subtotal: $_____________

SHIPPING CO. (if you are using your own account)

ACCOUNT #:

Shipping: $_____________

TOTAL: $_________________

Please remember to fax a copy of your tax exempt information (if applicable) when ordering.

Please allow seven (7) to fourteen (14) days to receive your order unless otherwise specified.

Start-Rite, Inc. reserves the right to substitute any item for one of equal or greater value.

Present your custom or pre-packaged kits in one of our beautiful printed bags:

BAGS

MINIMUM ORDER: All our products are sold in case quantities or a minimum of one gross (144) for hygiene kits.

Printable Order Form

PO Box 95
Middle Island, NY 11953
Tel: (631)205-1900 / Fax: (631)205-1593

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