Order Form

Print and use this form when ordering by mail or fax. You may also use this form for quotations.

Outdoorfireplaces.net
Brought to you by:
Venture Marketing Group
647 Port Sheldon ... Grandville, Mi. 49418
(616) 457-5847 fax

Ship to : Name: _________________________________________________________
Address: ______________________________________________________________
City: _________________________________________ State: _____ Zip: __________
Telephone: __________________________ Fax: ______________________________
E-mail Address: _________________________________________________________
Method of Payment: Money Order, VISA, Master Card ( circle one )
Credit Card Number: ____________________________________ Exp. Date: ___
Name on Card: _________________________________________________________
Card Address: _________________________________________________________
City: __________________________________________ State: _____ Zip: _________
Telephone: _________________________ Fax: _______________________________
Authorized Signature: _______________________________________ Date _________

QTY	-- ITEM NUMBER --	---------- DESCRIPTION ----------	--- EACH ---	---- TOTAL ----
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			-- Sub-Total	.
		Michigan Residents Add 6 % Sales Tax	-- Sales Tax	.
		Shipping Weight -	-- Shipping	.
			-- TOTAL	.

Sorry no checks or COD's.

Customer credit cards will be billed as Venture Marketing