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Greater America Distributing
FAX ORDER FORM
Fax to 816-531-4337
Date: _______________ Purchase Order No. __________
Phone No. ________________ Contact Name: ______________
Bill To: ___________________ Ship To: ___________________
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Ok to back order __ Ship only when complete __ Call if back ordered ___
Other ____________________________________________________
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Pickup______ Other ___________
Ship by: Ups___ Ground___ Blue ____ Red___ COD ___
Print this form and fill out as much as possible for best service.
We will confirm all orders before shipping.