If "OTHER" -- Please give details in Comment section
Required
SHIPPING INFORMATION
Business Name:
Required
Street Address: for Parcel Deliveries
a Street Address is required, even if mailing to P O Box.
"NONE" may be acceptable if there is no alternative, and quantity is 25 or less
Required
Mailing Address: for orders of 25 or less
use "SAME" if Street Address is postal delivery, too
Required
[City] [State] [Zip]
[ CITY ]
[ STATE ]
[ ZIP ] If Street and Mailing Address have
different zip codes, give DELIVERY zip. Orders of 25 or less are Mailed. Larger orders are delivered
to Street Address
Required
CounTy: ex: Paquotank, Dare
....
ADDITIONAL CONTACT INFORMATION
Contact Person:
Required
YOUR Web Page:
....
Email: n/a is acceptable
Required
Phone: (Area Code)
Required
Fax: (Area Code)
....
Order Quantity:
Required
Comment:
....
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