Active Order Form

Order Form

ACTIVE PLASTICS, Inc.
Offices: 9467 Kalamazoo Ave. Caledonia, MI 49316
Phone: 616-698-7095 Fax: 616-554-6024
Office Hours: M-F 10 am to 4 pm EST

Thank you for choosing Active Plastic's products!
To insure prompt and accurate delivery of your purchases, please provide complete and accurate information. To order by VISA, MasterCard, Discover or American Express now (non-SSL), complete this form online and click SUBMIT. You may also contact our sales office during EST business hours at 616-698-7095 (24 hr. voice mail also).

All items sold are customer-paid shipping via UPS or FEDERAL EXPRESS ground service. Shipping and handling will be added to your total purchase after packing and weighing. PACKAGING AND HANDLING FEES - some items are bulky/ fragile requiring additional packaging, handling care and insurance requirements. Your card is not charged until your order is confirmed and placed in process. ALL ORDERS ARE CONFIRMED TO YOU VIA E-MAIL PRIOR TO BILLING.

Purchaser Information: (BOLD items are required)

First Name
Last Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone 1
Phone 2
FAX
E-mail
Website URL

Please enter the product and price below:

QTY	Description & Price

	Credit Card Billing
Credit Card
Cardholder Name
Card Number
Expiration Date

Complete SHIPPING section if order is to be shipped to a different address than above.

	Shipping Information
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

Please print a copy of this order for your records.
Click only once. We will send receipt confirmation to your email address above by autoresponder and by personal email confirmation thereafter. Thank You!.

Copyright © 1999 Active Plastics, Inc. All rights reserved.