ABC Safety Network Mail-Order Form

ABC Safety Network Mail/Fax Order Form
Please print this form, fill it out and mail with check or money order payable to ABC Safety Network
or fax with credit card information. Do not fill out credit card info if mailing!
Mail: 381 Pine St. #4, West Reading, PA 19611
Toll-Free PHONE: 1-877-SAFE-T-51 (1-877-723-3851)
Toll-Free FAX: 1-888-206-0449
Web: www.abcsafety.net Email: abcsafetynet@yahoo.com

Please complete all fields for fastest service. Please remember to add 10% to the price of each clothing item size 2X and up. (2X adds 10%, 3X adds 20%, etc.)
If you are ordering for a tax-exempt organization, please include a copy of your IRS tax-exempt letter with this form. All other PA residents please add 6% sales tax (for non-clothing items only) below.
Not all items are in stock at all times. Please allow 2 to 4 weeks for delivery from the time we receive your order.

Your name: ______________________________________________________________________________________

Organization: _____________________________________________________________________________________

Shipping (street) address: ___________________________________________________________________________

City/State/Zip: _____________________________________________________________________________________

Phone(s): __________________________________________ Fax: __________________________________________

Best time to call: _________________________________ Email: ___________________________________________

Credit Card type: (VISA, MC, etc.)____________________ Number: _________________________________________

Expiration: ____________________ 3-digit security code on back: ______________
(Name and address of cardholder must match those given above. Please call 1-888-206-0449 or email abcsafetynet@yahoo.com to make other arrangements such as gift purchases.)

Item #

Description / Size (if applicable)

Quantity

Unit Price

Total

Subtotal:

(PA Sales Tax: Subtotal x .06):

Please add $8.00 shipping and handling for each $100.00 or less in the Subtotal (do not include tax for shipping purposes). Example: If the Subtotal is between $0.00 and $100.00, add $8.00. From $100.01 to $200.00, add $16.00, and so on.

Shipping:

Total:

Item #	Description / Size (if applicable)	Quantity	Unit Price	Total








			Subtotal:
		(PA Sales Tax: Subtotal x .06):
Please add $8.00 shipping and handling for each $100.00 or less in the Subtotal (do not include tax for shipping purposes). Example: If the Subtotal is between $0.00 and $100.00, add $8.00. From $100.01 to $200.00, add $16.00, and so on.			Shipping:
			Total: