Order Form

Printable Fill-In Order Form New Customers, please send signed resale form with your order. Resale Form Select One: New Customer Current Customer Retailer Please provide the following contact information:
Name		*Required
Store Name
Contact Phone		*Required
Fax
Email

		Billing
Street Address		*Required
Address (Cont.)
City		*Required
State/Province		*Required
Zip/Postal Code		*Required
Country

		Our account information is already on file at WCPC


		Credit Card Information (if applies)
Credit Card #		*No dashes
Expiration date		*example 00/00
Billing Zip Code
*If you do not feel comfortable submitting your credit card information via email, please print order form and fax to (818) 982-1756

		Delivery Methods
		WCPC Delivery UPS Ground

		Shipping *(if applies) UPS Charges Apply***
		Same as Billing Address
Street Address
Address (Cont.)
City
State/Province
Zip/Postal Code
Country
		** All orders are shipped UPS Ground
		* Please allow 3-5 business days to process order before shipping

Please provide the following ordering information:

Qty.	ea/pack/doz.	Item	Description (Item #)

or Print & Fax to (818) 982-1756

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No usage of these images will be allowed without our express written permission.