Waste Recovery Designed Products, Inc.

P.O. Box 179  McDonald, PA 15057   724-926-5110 (phone)  (724) 926-5114 (fax)

 

 

 

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PRINT THIS FORM AND FAX OR MAIL IT TO WRDP

Order Form

Sold To:

 

Name

Address

 

 

 

Phone Number

Ship To (if different):

 

Name

Address

 

 

 

Phone Number

Cust No.

 

Terms

 

Sales Person

 

Customer PO No.

Ship week of

 

Ship Via

 

F.O.B.

 

Routing

Type of Payment:

 

     Visa                      C.O.D

     Master Card          Check

     American Express

Acct No.                                         exp

 

Signature