B U L L S E Y E G L A S S - Have Glas

FORM
Ordering
70
Toll-free order line 888.220.3002 • Order online at www.bullseyeglass.com
Ordering
Use this form to list items. See the instructions on the following page for placing your order. If you know what you
want and need help with the details, just call one of our friendly customer service representatives.
ORDERED BY:
nAME
COMPAny
STREET ADDRESS
CITy STATE POSTAL CODE
COUnTRy
TELEPhOnE FAX
EMAIL ADDRESS
METHOD OF PaYMENT: VISA MASTERCARD AMERICAn EXPRESS ChECK #
CARD nUMBER EXP DATE
sHIP TO: if different from “Ordered by”
STyLE/ITEM CODE P/F* PAGE # ITEM DESCRIPTIOn SIZE PRICE QUAnTITy TOTAL
nAME
COMPAny
STREET ADDRESS
CITy STATE POSTAL CODE
COUnTRy
TELEPhOnE FAX
EMAIL ADDRESS
SIGnATURE DATE
* For sheet glass choose either standard (P) or fusible (F) where applicable.
** To obtain a shipping total, call, fax, or email your order and a representative will call you to discuss shipping.
PRODUCT TOTAL
ShIPPInG/hAnDLInG**
ORDER TOTAL