Discount Rotary

Order From

Please print out this order form and fax or mail it to the address below.

                                      

Quantity          Item ID         Item Description Price of Item
       
       
       
       
       
       
       
       
       
       
       
       
       
    Subtotal  
    7% Tax NJ residents only  
    Shipping ($10.00 covers most orders. We'll contact you if additional shipping is required) $10.00
    Total  

 

Your Name:
Address:
Phone #:                                                              Fax #:                                             email Address:
Visa/Mastercard #:                                                                         Expiration Date:
 

 

Mail or Fax this form to:
Jan L Company Inc.
26 Mill Street
Mount Holly, NJ 08060
Phone #: (609) 261-1133  /  Fax #: (609) 261-1167

Prices Subject To Change

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