Patmar® "Poly Signboard" Order Form...

Shipping your order: All orders will be shipped freight collect by the carrier that the customer specifies. If the customer does not choose a carrier, Patmar will do so after making a reasonable effort to secure an acceptable rate. If customer wishes to ship by UPS or FedEx the customer must supply Patmar with their account number. Please supply this number in the "Comments" box being sure to specify which carrier you wish to use. Patmar will send each customer a return email detailing the charges made to the customer's credit card.  Account Information Card Type Visa MasterCard Amex Discover Card Number (no spaces or dashes required) Expiration Date (no spaces or dashes required) Name on Card Your Name: Title: Company: Telephone: Fax: E-mail:  Shipping Information Address: City: State: Click to Select Alabama Alaska Alberta American Samoa Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York North Carolina North Dakota Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory Not On List Zip Code: Ship to address above Shipping Address fill out the fields below: Ship to Address: Ship to City: Ship to State: Click to Select Alabama Alaska Alberta American Samoa Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York North Carolina North Dakota Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory Not On List Ship to Zip Code:  Product Order Information Sign Type & Size:     Quantity  Scored - Select - 22" Way28" Way  22" x 28" - Select - Plain Single Scored ¾" Dbl Scored Sheet Count - Select - 3,500 2,000 1,500 1,000 500 300 100 minimum  Scored - Select - 28" Way44" Way  28" x 44" - Select - Plain Single Scored ¾" Dbl Scored Sheet Count - Select - 1,500 1,000 750 500 350 200 minimum Note: All minimum quantities are assessed an additional $7.50 handling charge    Questions & Comments: