Order By Fax (Credit Card Required)

If you wish to order by credit card but prefer to place your order by FAX rather than online, and you are located in the continental United States, please print this page, fill out the order form and fax it to 1-866-883-2282. Please do not fax Purchase Orders of any kind. Payment is by Credit Card ONLY. $40 minimum order required.

Email Address (example: JohnDoe@aol.com):_____________________________________

Shipping Address (No Post Office boxes please.)
Name: _______________________________________________________________

Company Name:________________________________________________________

Street Address: _____________________________________________________

City:_______________________________ State:_________________

Zip Code:______________________ Phone:______________________

Item Code & Description Price Quantity Example: #53-8400 5 Inch 8 Hole 400 Grit Hook & Loop Discs 50-Pack 11.95 1
_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________


Card Number: ________________________________ Expiration Date: _____/________

Last 3 digits on Signature Panel on back of card: _______ VISA/MasterCard/Discover Only. If AmEx, 4 digit code from front of card.

Cardholder Name:____________________________________________________________

Credit Card Billing Address:________________________________________________

City:_____________________________________ State:___________

Zip Code:______________________ Phone:__________________

Signature:___________________________________________ Date:____/____/______