Theo B. Price, Inc.


Printable Merchandise Order Form

If you see any items on our web site that you would like to order, please print this form, return to the page which you saw the item, write a description of the item along with the price listed. Fax the form to us at (570) 595-3630 and we will call you to verify your order and get your payment details. Or if you prefer, you can print this form and fill it in but then go to our email form with the button below. Fill in the form and type your order information in the message box, press the send button to submit the form to us and we will then call you to verify the order information.

Mail to Theo B. Price, Inc.


Date:__________________ Phone:_____________________
Name:_____________________________________________
Address:___________________________________________
City, State, Zip:_____________________________________

Qty.
Description
Price Subtotal
       
       
       
       
       
       
       
       
       
       
       
       
TOTAL  

We Accept: Mastercard, Visa, American Express, Discover, Carte Blanche, Diners Club


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