Fax order form for Pegs Locking Hooks (tm)

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Complete this form & print

FAX to: 800.341.9725 or 256.882.2414
CALL us: 800.889.7674 or 256.882.2121

Pegs Locking Hooks^tm Order Form Prices Effective: 2/22/2002
ITEM	COLOR	# of Packs (12 per pack)	PRICE	TOTAL
L-Pegs^tm	Red	packs	x $	$
L-Pegs^tm	Yellow	packs	x $	$
L-Pegs^tm	White	packs	x $	$
L-Pegs^tm	Black	packs	x $	$
J-Pegs^tm	Red	packs	x $	$
J-Pegs^tm	Yellow	packs	x $	$
J-Pegs^tm	White	packs	x $	$
J-Pegs^tm	Black	packs	x $	$
			Sub-total:	$
$20-%10 $30-%15 $50-%20 Your discount!:			%	$
Alabama Resident add 4% sales tax			Tax:	$
New total with discount and taxes:				$
Shipping & Handling ($3.75 + shipping cost):				$____________
Total:				$

Ship To Information: Please Print
Name:
Address1:
Address2:
City:		State:		Zip:
Phone:	()-		Ship Via:
Email (optional):

Credit Card Information: Check appropriate card:
Card #:	-- -
Expiration Date (MM/YY):	/
Signature:			Name as Appears on Card:

Credit Card Billing Information:			Same as shipping address
Address1:
Address2:
City:		State:		Zip:

Copyright^© 1999-2008 * American Precision Products * all rights reserved
(800) 889-7674
info@PegsLockingHooks.com
Jan. 4, 2000