HorseTech.com
Offline Order Form
Coupon or Member #: No:______________
Fax to HorseTech.com at (712) 841-4662 |
||
Print this form with your printer. Complete the order form by entering a Name, Size and Quantity for each item desired. You may want to calculate the total for your own records, however, it is not required that you make these calculations. Applicable sales tax (IA residents) and shipping will be added to your order. Add your Credit Card Information and Fax the completed form to (712) 841-4662 You must complete credit card information in order to process your order. Please print neatly when completing the form. You may also order by phone. Place your orders by calling toll free at 1-800-831-3309. If you have any questions or problems with regard to your offline order, please call us at 1-800-831-3309, M-F 8:00 AM to 5:00 PM Central.. |
||
Order Information
| Product Name | Size (lb) | Quantity | x Price | = Total |
Thank You for Your Order! |
Total |
|||
Shipping Information
| Name | ||
| Street Address (No P.O. Box) | ||
| City | State |
Zip |
| Phone ( ) | Email Address | |
Special Shipping Requirements?: |
||
Credit Card Information
| Name On Card | |
| Credit Card Type (circle one) | Visa MasterCard American Exp. Discover |
| Card Number (print Clearly) | |
| Expires (MM/YY) |
Credit Card billing Address (if Different from Shipping Address above)
| Billing Address (if different from Above) |
Street Address |
| City |
State |
|
Zip |
|