| ORDER FORM | Flounder Pounder Marine & Trading Co., Inc. 750-C Mullet Rd. Cape Canaveral, FL 32920 |
|
Phone 321-868-1688 Fax 321-868-1680 |
Website: WWW.FPMARINE.COM Email: SALES@FPMARINE.COM |
| Please print this form and fax to 321-868-1680. we will contact you with shipping charges |
$25.00 minimum
| P.O. Number | Date |
| Part # if applicable | Description | Qty. | Price | Total |
| Subtotal | ||
|
call 321-868-1688 or email sales@fpmarine.com for rates |
Shipping | |
| Total |
CUSTOMER INFORMATION (please fill out all fields, we do not share information with anyone)
| BILLING ADDRESS for Credit Card: | SHIP TO ADDRESS (if different): |
| Name | Name |
| Address | Address |
| City | City |
| State (Province), Zip (Postal Code) | State (Province), Zip(postal code) |
| Email: | Telephone: |
PAYMENT METHOD VISA or MASTERCARD only
| Card # | Expiration date: |
| CVV2 # (3 digit on back) | Signature X: |