E-MAILABLE ORDER FORM
Using the browsers edit function, select and copy the below text, then click on the below E-mail address
and click paste in the body of the E-mail. The form can be filled in and sent to ChokeFree Pets via E-mail
to terryd@palmnet.net
CHOKEFREE™ ORDER FORM / INVOICE*
*For Resale / Dealers Only
CHOKEFREE™ Pets
1976 Sykes
Creek Drive
Phone: 321-223-4015
℅
Assured Solutions, LLC Merritt
Island, FL 32953 Fax: 321-453-6854
Please refer to
www.chokefree.com for a current listing of sizes, colors & information.
Date:
Company Name:
Contact Name:
Shipping Address:
Phone/Fax:
Buyer Resale Tax I.D.
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Size |
Color Description |
Quantity |
Price/Each |
Invoice Amount |
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Sub-Total of all items ordered on this page and continuation page. ORDER SUBTOTAL: |
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S&H –Sm Env up to 13
oz: $5.00, Sm Flat Rate: $7.00, Med
Flat Rate: $13.00, Lg Flat Rate: $17.00 |
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ORDER TOTAL |
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CREDIT CARD TYPE & CARD NO:
EXPIRATION DATE:
THREE DIGIT CODE:
CARDHOLDER NAME:
BILLING ADDRESS:
