SKC Quick Order Form PDF Fax Int'l

User Manual: Fax Order Form Int'l

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SKC Quick Order 800-752-8476
724-941-1369 (Outside U.S.)
Bill To
(Must match address on credit card account)
Name _________________________________________
Company ______________________________________
Address _______________________________________
______________________________________________
Div/MStop/Ste# _________________________________
City __________________________________________
State ___________ Zip Code ___________________
Phone ________________________________ (required)
A/P Contact ____________________________________
Email _________________________________________
Ship To
(If different-complete)
Name _________________________________________
Company ______________________________________
Address _______________________________________
______________________________________________
Div/MStop/Ste# _________________________________
City __________________________________________
State ___________ Zip Code ___________________
Phone ________________________________________
Email _________________________________________
Catalog No Description Qty Price/Ea Total
Method of Payment
______ New Account
(Completed credit application required)
______ Bill SKC Account # ______________________
Net 30 to accounts with existing credit
______ Purchase Order No. _____________________
______ MasterCard ______ VISA
______ AMEX ______ Discover
Card # ________________________________
Exp Date _________ Security Code ________
Signature ______________________________
Name on Card __________________________
Special Instructions __________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
Shipping Method
FOB Shipping Point
Carrier ________________________________________
Cust. Freight Acct # ______________________________
Partial Ship? ___________ Yes _____________ No
Total
SKC Inc.
863 Valley View Road, Eighty Four, PA 15330 U.S.A.
Tel: 800-752-8472 Fax: 800-752-8476 www.skcinc.com
724-941-1369 (Outside U.S.)

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