Order form 2012 sheet1
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Order form for recycled products from www.closetheloop.com
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Order form 2012 sheet1
- 1. Close the Loop, LLC 773 Upper Middle Creek Rd. Kunkletown, PA 18058 Phone: 570.629.8414 FAX: 570.213.4254 www.closetheloop.com ORDER FORM email: info@closetheloop.com Date: __________________ Ship To: _________________________________________________________ _________________________________________________________ _________________________________________________________ Phone: _____________________ PO#: __________ Ordered By: ______________ QTY Item Number Description Price Each Total Circle One: VISA MasterCard AMEX Discover Tax: ____________________ Credit Card# ________________________________ Shipping: ________________ Expiration: ___________ Sec. Code: ___________ Grand Total: ______________ Your Email Address: for order confirmation tracking: ___________________________________________