Procutlery Home Page                  518-634-2240

Form - Print Form, fill out and m     Mail-In Order Form fax in.   

  Fill out order form and mail order to: 

 

Allied Services "PROcutlery"              

8974 Route 32 ~ Freehold, NY 12431

OR Fax    order in to: 518-634-2573  

  Method of Payment:        Check___ Make checks payable to: Allied Services  Money Order___  Credit Card ____

  Type of Credit Card:______  Credit Card#  __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __ Exp Date: Month ___  Year___

   Signature: ____________________________________________     Name & address of Credit Card Holder if different from Ship to  Address

  Ship To: Name:_____________________________  Bill To: Name: _____________________________

  Street: ___________________________________  Street: ___________________________________

  City, State, Zip:______________________________ City, State, Zip: ___________________________

  Phone: (        ) _____-________

Qty

Item#

Description

Price Each

Total Price

         
         
         
         
         
       
Sub Total  
Shipping  
NYS 8.25%  
Total  

Shipping Table:

 
$  00 - $ 50 $ 9.00
$  51 - $100 $12.00
$101 -$150 $15.00
$150 -$300 $20.00
$301 -$450 $24.00
Over $450 $35.00

 

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