Mail Order Form

PRINT THIS FORM, FILL IT OUT,  &  MAIL TO  FLEX-MATS Inc.

Shipping Information

Name______________________________________________
Address ____________________________________________
City________________________________________________
State/Zip____________________________________________
Home phone_________________________________________
Other phone_________________________________________
E Mail______________________________________________

Billing Information/Payment Amount $______________

Check, Money Order, Visa or MasterCard (circle one)
Acct#_______________________________________________
Expiration date_________________
Billing name & address if different from shipping info
____________________________________________________
____________________________________________________
____________________________________________________  

Product Selection

Item Description______________________________________
Item #______________________________________________
Quantity________________________
Size____________________________
Color___________________________
Price___________________________
Shipping cost____________________

Product selection

Item Description_______________________________________  
Item #_______________________________________________  
Quantity_____________________
Size_________________________
Color________________________
Price________________________
Shipping cost_________________

Print this form, fill it out, and mail to:

            FLEX-MATS Inc.