One Cryo Cryogenic Tempering - Shipping and Order Form

Cryogenic Tempering Shipping and Order Form

Print Out The Form Below And FAX It or Send It Along With Your Items To Be Treated

SHIP YOUR MATERIALS TO US::

One Cryo INC.
14504 Old Military Rd.
Puyallup WA 98374

ORDER FORM

Your Name : Today's Date :

Company Name ( if applicable ) :

Day Time Phone # ( ) - Home # ( ) -

Wk # ( ) - ext. Fax # ( ) -

Email Address :

Billing Address

City : State : Zip :

Shipping Address :

City : State : Zip :

If Business

Use Purchase Order : Yes / No

Purchasing Agent Name :

Previous Customer ? Yes / No Customer # :

How Did You Hear About Us ?

Notes :

Payment Method : Credit Cash Money Order Check COD's add $10.00 per Box

VISA M/C AMEX DISCOVER Credit Card # Expiration Date:

Name On Card (print)

Signature :

Return Shipping Preference : UPS Ground 3-Day 2-Day Next Day Air ( circle one )

Other, please specify :

Return Address : Commercial or Residential (circle one)

Return Insurance Requested :

Name of Sales Rep :

SHIPPING FORM (OFFICE USE ONLY)

Purchase Order Number : Run Date :

Total Shipping Weight : Shipping Co.

Total # of Boxes Shipped Weight Each Box :

Note Any Damage :

Note Packaging :

Note Special Instructions :

CUSTOMER: PLEASE COMPLETE DESCRIPTION OF GOODS

DESCRIPTION of ITEMS Condition, New / Used	QTY	Weight	Total Weight	Cryo Cost	Total Cost Cryo
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.	.	.	.	.HANDLING	$5.00
TOTALS	.	.	.	.	.

Office Use Only

SHIP TO: One Cryo INC 14505 - Old Military Rd. E Puyallup WA 98374