Lapcraft, Inc. Order Form

  Please provide the following ordering information.  The information you provide below will never be sold or given to anyone.  Required fields are in *purple.

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Billing Information Shipping Information
Customer Number:
 Customer Number:
Company Name:
 Company Name:
Contact Name:
 Contact Name:
Address 1:
 Address 1:
Address 2:
 Address 2:
City
 City
U.S. State
 		U.S. State
Country: 
 		Country: 
Zip Code
 Zip Code
Phone
 Phone
Fax
 Fax
Email Required
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Order Form

Quantity Stock Number Description Unit Price Amount

Total Merchandise
 
Sales Tax (Ohio Res.  5.75%)
Total Amount of Order
Balance Due
Payment Method
Cardholder name
Card number
Expiration date

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Copyright © 1999 Lapcraft, Inc. All rights reserved.

Lapcraft, Inc.®
195 West Olentangy Street
Powell, OH  43065  USA

CustService@Lapcraft.com
 Phone (614) 764-8993 ¨ Sales (800) 432-4748 ¨ FAX (614) 764-1860

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