Order Form for Non-Beverages

Product Order Form
Use this form to order non-beverage products on-line
(Order Beverages)

All computer orders must be received no later than 5 pm on the day prior to your regularly scheduled delivery day.

All orders, pricing and expected delivery dates will be confirmed telephonically. An order number will be provided to submit with your payment.


Company Name (Required)

Contact (Required)

Telephone (Required)

Address

City

St.

Zip


Fax

E-Mail

Qty	Description

Enter any special instructions in the space provided below:

Private Label Specialties, Ltd. will contact you to confirm your order and pricing, and to make arrangements for payment. An Order Number will be assigned at that time.

If you want your name on it, we can do it . . .


	Toll Free: 888-669-6632

	Fax: 603-641-2266