Durable Plastic Design,
LLC.
Order Form
(printable)
Durable Plastic Design, LLC.
17725 NE 65th Street, A-100
Redmond, WA 98052
(425) 883-2570
Name:_________________________________Phone:__________Fax:_________
Company:__________________________________________________________
Address 1:_________________________________________________________
Address 2:_________________________________________________________
City:_______________________STATE/PROV________ZIP/POSTAL__________
Country:__________________ E-Mail (optional)____________________________
Note: We ship only to street addresses...NO
P.O. Boxes please!
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Washington Residents add (8.80%) ___________
Total Enclosed ___________
Bill this order to my [ ] Visa [ ] Master
[ ] Discover
Card Card Number: ________________________ Expiry Date: ____/____ Cardholder
Name: ____________________________________
Cardholder Signature: _________________________________
OR
Enclose Check or Money Order for full amount.
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