MAIL ORDER TO:
PHIL-E-SLIDE Inc.
FAX ORDERS TO
(603) 898-5538

EMAIL ORDERS TO
orders@phil-e-slide-us.com
PO BOX 206
Salem, NH   03079
                           
ORDER FORM
Company________________________________________________________________
First Name _________________________ Last Name   _____________________________
Address ____________________________ City_______________State_______________ Zip_______________
Phone (______)_________________________   FAX_______________________________
__________________________________________   Email _____________________________________
Product Code
   __________
   __________
   __________
   __________
   __________
   __________
   __________		 Description
_________________
_________________
_________________
_________________
_________________
_________________
_________________		 Size
   __________
   __________
   __________
   __________
   __________
   __________
   __________		 Qty.
   __________
   __________
   __________
   __________
   __________
   __________
   __________		 Price Each
   $__________
   $__________
   $__________
   $__________
   $__________
   $__________
   $__________		 Total
   $__________
   $__________
   $__________
   $__________
   $__________
   $__________
   $__________
Total Items $___________
  __________
Notes
Total Price
$__________
Shipping and Handling (see chart)
Total Due $__________
SHIPPING METHOD (UPS / USPS)   (Check One)
   __GROUD  __ PRIORITY AIR (SECOND DAY)  
   Order   Subtotal
   $00.00 to $99.99 =
   $100.00 to $199.99 =
   $200.00 to $499.99 =
   $500.00 to $999.99 =
   $1000.00 & up =		 GROUND  
   $10.95
   $14.95
   $17.95
   $29.95
   QUOTE		 PRIORITY
   $22.95
   $26.95
   $29.95
   $49.95
QUOTE
METHOD OF PAYMENT (Check One)    No CODs Please

   __ Check or Money Order enclosed (payable to PHIL-E-SLIDE INC)
__ VISA  __ Master Card  __ American Express  __ Discover

CARD NUMBER: __   __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

Expiration   Date: Month __ __ Year __ __

   _____________________________  _____________________
Signature                                               Date
1