Supplies Order Form
 Our online shopping cart is currently under construction. Until we are able to get that up and running, please fill out this form completely if you want to order supplies. All of our compatible cartridges come with a lifetime warranty for quality assurance. Please note that payment will be due upon delivery for all new customers.

UNLESS OTHERWISE SPECIFIED, WE WILL SEND COMPATIBLE SUPPLIES WHERE AVAILABLE.

Name:
Company:
Phone:
Fax:
E-Mail:
Address:
City:
State/Zip:
   

Priority:
LOW - This is a back up, no rush
MEDIUM - We need it tomorrow
HIGH - We need it NOW

SUPPLIES NEEDED:
Item/Qty:   
Item/Qty:   
Item/Qty:   
Item/Qty:   
Item/Qty:   
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Payment Method:
Cash
Check
Visa/Mastercard
American Express/Discover
Terms (existing customers only)
Refferred By:

Additional Comments: