PROFESSIONAL HARDWARE'S Fax/Mail-In Order Form Lampstuff.com division / Upholsterystuff.com division Toll Free Fax - 1-888-836-1919 / Mail To: PO Box 11800 - Casa Grande AZ 85130 Note: MINIMUM ORDER $15.00 This form may be typed on your computer and will calculate the shipping charges automatically. Shipping & Handling - Contiguous 48 states Only:
15.00 to 30.00..............7.85 30.01 to 50.00...............9.25 50.01 to 75.00............10.95 75.01 to 100.00...........11.95 100.01 to 125.00.......13.95 125.01 to 150.00........14.95 150.01 to 175.00.......15.95 175.01 to 200.00........18.95 200.01 to 250.00.......21.95 250.01 to 300.00........23.95 300.01 to....................26.95 Name:Company Name (if applicable): Street Address - Include Suite/Apt #:Press PRINT button. Then fax or mail to: Professional Hardware & Supply CompanyCity: State: Zip/Postal Code: Country: USA CANADA Phone Numbers: Day: Evening: Your e-mail address:Payment Option:(Choose one) Mastercard Visa Discover Amer Express Money Order/Check in US Funds.Cardholder Name EXACTLY as it appears on your Credit Card: Credit Card billing address if different than above:
Card Number: Expiration Date: Security Code: (3 or 4 digits)
Quantity Product # Description Cost Total Merchandise Total: Total Including Shipping: