http://www.eliterugs.com/

FAX/MAIL ORDER FORM

Print and Mail or FAX to: Elite Rugs 54 Kool Place Port Jefferson Station, NY 11776
FAX: 631-331-2933  Email: sales@eliterugs.com
 
PLEASE PRINT

ORDERED BY

SHIP TO (If Different)

Name    
Address    
 City/State   Zip:   Zip:
 Day Phone    
Alt. Phone    
FAX    
E-mail    

Shipping Address is a __ Residence    __Business

QTY

SIZE

DESCRIPTION

UNIT PRICE

TOTAL

         
         
         
         
         
         
         
         
         
 
Card Number:  

Sub Total

  
Expiry Date:

* Shipping

  FREE
Card Type:  

** State Tax

  
Cardholder:

*** Total

  

If sending payment, please enclose check or money order, payable to Ravin Enterprises

TERMS: Net cash with order. Orders will be shipped upon receipt of payment.

* Shipping and handling Charges: We Offer Free Shipping And Handling On All Orders With In The Continental United States. Shipping Cost To Alaska, Hawaii, And Canada Will Be Added To Your Order.** New York Residents Please Add 8.65% Sales Tax To Your Order.*** You Will Be Contacted If The Total Differs.