ORDER FORM

E-mail: 1942@localaccess.com

Your Address


Your Name
Your daytime phone
Street
City
State, Zip
A gift from
E-mail
 

Shipping Address if not the same


Name
Street
City
State, Zip
 
 
PAYMENT OPTIONS
  • Order directly with this form. Please press the SUBMIT button when done 
  • Choose call , as card type, we will call to confirm your order 
Cardholder Name 
Card 
number exp. date 
 
CHOOSE PRODUCT NAME 
CALL BUTTON 
1. STOCK NO.
2. STOCK NO.
3. STOCK NO.
4. STOCK NO.
5. STOCK NO.
6. STOCK NO.
7. STOCK NO.
 
1. PRICE $
2. PRICE $
3. PRICE $
4. PRICE $
5. PRICE$
6. PRICE $
7.PRICE $
 
 
TOTAL
Washington Residents please add 7.6% sales tax for items shipped to Washington addresses only
We will add the shipping and handling charges into to your bill. We will then send you a statement of you bill by email. We will also let you know by email when your perches has been shipped and method of shipping.

The Shipping Address is a
residence
business

Back to the ROBERTS SALES AND SERVICE
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