Pondliners.com Order Form
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You may place an order by printing this form, filling in payment information and information for the product(s), then either fax or mail it to the address below.

PRINT ORDER FORM

Payment Method:

_____ Money Order (Please allow 2-4 weeks delivery)
_____ Certified Check (Please allow 2-4 weeks delivery)
_____ Credit Card (Please allow 1-2 weeks delivery)
_____ C.O.D. (Please allow 1-2 weeks delivery)

Name: __________________________________________________
Company Name: _________________________________________
Address: ________________________________________________
City: __________________________ State:____________________ Zip:_________
Telephone #: _______________________
Fax #: _______________________
E-mail Address: _____________________________________
Company Web Site: __________________________________________

Credit Card Payment Information:

_____ Visa
_____ MasterCard

Name Shown on Credit Card: ______________________________________________
Credit Card Number: __________-__________-__________-__________
Expiration Date (Month/Year): _______________
Signature (Required): _________________________________________
Date (Required): ____________________

Order Information:

Order Total: ____________
KY Residents, Add 6% Sales Tax: ____________
Add Shipping and Handling (refer to shipping schedule below): ____________
GRAND TOTAL: _____________________________

Shipping:

Please call or e-mail us for a shipping rate and include your zip code.
Liners weighing 151 lbs or more will be shipped common carrier.

FOR INTERNATIONAL ORDERS, PLEASE CALL FOR SHIPPING RATES

Thank you for your order!