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Business
Services 119 N. Clinton Ave.
St. Johns, Michigan 48879 Phone: 989-224-1631 Email info@bztechservices.com |
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Print and include this with the shipment. |
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Order Date: |
_____/_____/______ |
Date Required: |
_____/_____/______ |
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ORDERED BY |
SHIP TO (If Different) |
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Name |
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Name |
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Address |
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Suite / # |
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City/State |
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Zip: |
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Zip: |
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Day Phone |
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Alt. Phone |
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FAX |
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Shipping Address is a ______ Residence ______Business |
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QTY |
UNITS |
DESCRIPTION |
UNIT
PRICE |
TOTAL |
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Shipping Charges will
be in addition to the total above: |
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BILLING |
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Credit Card |
_______M/C _______VISA |
Sub Total |
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Cardholder Name |
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*S/H |
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Card Number |
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Other |
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Expiration Date |
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Amt. Due |
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NOTES:
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TERMS: Net
cash with order. Orders will be shipped upon receipt of payment. You
may use your MasterCard or VISA. Overpayments will be credited to
your next order. All orders subject to price at time of shipment. |