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Order Form

 

This Order Form will only hold 20 items.  If you need more room, the SUBMIT on the first Order Form and then fill out a second order form.  On the second form,  you need not fill out all the Bill or Ship to Information.  However, you will need to put in the Bill To - the name of your Company or Organization and then Page 2, 3, 4, etc.

Use the TAB Key to from one box to the next or use your mouse. 
DO NOT Press ENTER or it will send the form

Bill To: Ship To:
Company/Organization Company/Organization
Address1 Address1
Address 2 Address 2
Address 3 Address 3
City/State/Zip Address 4

If you are outside North America, please enter the City, Country, Zip or APO number.
 

Quantity U/M Item Code Description Price Each Amount

SubTotal:

Shipping & Handling:

10%
of subtotal

Total:


Comments and or color, lettering, etc.

Contact Person: *
Phone Number:
Fax Number:
Email Address: *

* Required field

  

Payment Method:

Check:    (Make checks payable to Dillard Government Sales

Purchase Order No.:  

Credit Card:    Card Credit Number:

                                                          Name on Card.........:

                                                          Expiration Date........:


Phone: 800-225-8326 Email: dgs@carol.net Fax: 864-964-9104

Dillard Government Sales
Copyright 2003

Spalding Computer Services

 02/04/2008