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The Avenue Group Order Form

 

Please enter your information below:


1.  Name:                  
2.  Company:               
3.  Telephone:            
4.  Street Address:        
5.  City:                  
6.  State:                 
7.  Country:               
8.  Zip/Postal Code:       
9.  Purchase Order No.:   
10. Email Address:         
11. PAYMENT OPTIONS:      
Option #1
If Open Account:
12. Account No.:          
Option #2
If credit card:
13. Credit Card Type:     
14. Credit Card No.:      
15. Credit Card Exp. Date:
16. Name on Credit Card:   
17. Product Manufacturer: 
18. Part # Of Item:       

18a. Enter Description
     If Part # Not Found 
                          

18b. Item Model #         

18c. Location Code 
     If Applicable        

19. Process Of Order:     
20. How To Ship Order:    

21. Please Enter Comments.

After filling out form, press send. If you prefer, print out this form and send it to us using your fax machine to our 24-hour Toll Free Fax Line: (630) 543-3299. Thanks for shopping.

 


 


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This page was created by Avenue Four Solutions, Inc. (630 543 5500) on Wednesday, December 31, 1997.
To send E-Mail to one of our other companies click on mail box

Information please call (630) 543-5500, Orders 1-800-SAVETIM(e) or E-Mail to Avenue Four Solutions, Inc.