for plastics
DESCRIPTION
For PlasticsTRANSCRIPT
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OrderForm.doc 9/4/2006
Order Form Tel: 586-949-3527 Website: http://www.polymers.eezway.com/ E-Mail [email protected]
No telephone orders or purchase orders please.Send completed form to: Enter the information below Please print clearly!
EEZWAY 45931 Edgewater Dr. New Baltimore, MI 48047
Name: _______________________________________________
Address: _____________________________________________
Address: _____________________________________________
City: _________________________________
State: ________________________ Zip: ______________
E-Mail: ________________________________
*Shipping charge applies only once per item#
Item # Description Shipping* Quantity Price
POLYKIT Polymer Sample Kit Shipping: ($4.50 s&h + $1.00/ea. additional kit)* $10.00ea x =
PS-2oz Polystyrene Refill Shipping: ($1.00 s&h)* $2.00ea x =
PP-2oz Polypropylene Refill Shipping: ($1.00 s&h) $2.00ea x =
PVC-2oz Polyvinyl Chloride Refill Shipping: ($1.00 s&h)* $2.00ea x =
LDPE-2oz Low Density Polyethylene Refill Shipping: ($1.00 s&h)* $2.00ea x =
HDPE-2oz High Density Polyethylene Refill Shipping: ($1.00 s&h)* $2.00ea x =
PC-2oz Polycarbonate Refill Shipping: ($1.00 s&h)* $2.00ea x =
PETE-2oz Polyethylene Terephthalate
($1.00 s&h)*
PMMA-2oz Polymethylmethacrylate Refill Shipping: ($1.00 s&h)* $2.00ea x =
N66-2oz Nylon-66 Refill Shipping: ($1.00 s&h)* $2.00ea x =
BB-12 Big Bands-Rubber Bands 1doz/pk 7x1/8 inch Shipping: ($1.00 s&h + $0.50/ea. additional pk) $1.39pk x =
BR-12 Big Red-Rubber Bands 1doz/pk 8-1/2x1/4 inch Shipping: ($1.00 s&h + $0.50/ea. additional pk) $1.59pk x =
Shipping Sub-total (Enter Below) Sub-Total
*Shipping charge applies only once per item# Michigan addresses include 6% sales tax
Shipping
Please remit this amount with your order. Total
Send completed order form along with your payment to:
EEZWAY 45931 Edgewater Dr. New Baltimore, MI, 48047
Make checks and money orders payable to: EEZWAY. No telephone orders or purchase orders please. Orders are shipped via the US Postal Service, Parcel Post. Please allow 2-3 weeks for delivery.