ThermoformEquip.com - AL-Tool / T-Lam Order Form

Secure AL-Tool/T-Lam Order Form

* Contact Name:
* Shipping Address:
* City:
* State:
* Zip:
* Country:
* Telephone Number:	( ) -
Fax Number:	( ) -
* Email Address:

Quantity AL-Tool 1 Gallon Bags: 1-19 bags @ $68.00 Ea. 20 or more bags @ $61.20 Ea.

Quantity T-Lam 1 Gallon Bags: 1-19 bags @ $28.20 Ea. 20 or more bags @ $25.40 Ea.

* Credit Card Type:	MC Visa Amex Disc
* Credit Card Number:
* Expiration Date:	Ex. 01/07
* CVV2:	(3 digit on back of card)
* Card Holder Name:
Card Holder Billing Address: (if different from shipping address)
Purchase Order Number:
Comments:
**

**Completing this form and clicking the "Go To Step 2" button will not generate a charge to your Credit Card, but will take you to a printable page with your order information, that you can then sign and FAX to us. Upon receipt of your FAX, we will contact you with the total, including shipping charges which will be computed by your region, shipper and the weight of your order.