ORDER FORM

Business Name Date

P.O.# Buyer's Name

Address City State

Phone Fax Email

Type of Business # of Locations

Product

Quantity

Price
Gum Zapper
Mini Gum Zapper
Srpingclean
Wand Brush
  Shipping & Handling
Subtotal

 

 

 

 

 

 

 

 
 
ORDERS ARE SHIPPED GROUND SERVICE UNLESS OTHERWISE SPECIFIED.
SHIPPING COSTS WILL BE GIVEN AT TIME OF CONFIRMATION.
Subtotal
Tax (CA only, add 7.75%)
Total

Method of Payment Visa Mastercard American Express Discover

Name on Card
Card #
Expiration Date
...

 

1-800-269-3393 Fax 619-741-7326 zappermaster@zapperproducts.com