wholesale Order Form

Firm: 
Purchasing Agent Name: 
   Address: 
   City:  State:    Zip: 
   Phone Number:  (so we can call with any questions) 
   E-mail Address:         

(so we can notify you when your order is shipped)

  Seller's Tax I.D. number: 

Since we are still a small family business, we do not take credit cards. Only orders with a check or money order will be shipped. Please do not send cash.  Simply fill out the form below, then print it and mail it with your payment.  Thank you.