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 On-line Ordering Form

This order form can be printed and mailed or faxed.
1-530-534-9956    FAX 1-530-534-1170

Full Name:
Address:
City:
Zip Code:  State:  Country:
Email:
Telephone: (Required to help expedite order)
Fax:
Item Quan. Description Price Each Total Price
1

 
2

 
3

 
4

 
5

 
Merchandise Total
California Residents Add 8.25% Sales Tax
Shipping Charge Total
Grand Total
 
 
Credit Card: Expiration Date:
Account Number:
or

You can place your order by phone: 1-530-534-9956.  Please have your credit card handy.

 

This site has been designed and maintained by G K 
Copyright 2006 by Surplus City. All rights reserved