How to Order By Fax

Fill out form, print from your browser and fax to: 708-824-1410

Village Supplies LTD™ · P.O. Box 605 · Oak Lawn, IL 60454
PHONE: 708-824-1402 · FAX: 708-824-1410

NAME:

PHONE NUMBER WITH AREA CODE (REQUIRED)

COMPANY OR SCHOOL NAME:

ATTENTION:

SHIP TO ADDRESS (NO P.O. BOX NUMBERS)

APT./FLOOR/SUITE	CITY	STATE	ZIP CODE

RESIDENCE
BUSINESS

E-MAIL (REQUIRED)

QUANTITY	ITEM NUMBER	DESCRIPTION	PRICE







		TOTAL

PLEASE NOTE: WE HAVE A $20.00 PRODUCT MINIMUM (before shipping) FOR EACH ORDER. WE WILL NOT PROCESS ORDERS UNDER THIS MINIMUM.

ILLINOIS RESIDENTS ADD 8.50% SALES TAX. WE WILL ADD UPS CHARGES FROM Alsip, IL TO YOUR ORDER.

TO CALCULATE SHIPPING CHARGE: USE THE ADD TO CART BUTTON ON OUR SHOPPING CART SOFTWARE. THIS IS THE SHIPPING CHARGE THAT WE WILL CHARGE YOU.

Payment Method (required).
Please fill out the following completely. Orders without payment method specified will not be processed.
VISA MasterCard American Express

Cardholder name

Card number	Expiration date

CID number from back of the card

CLICK THE PRINT BUTTON ON YOUR BROWSER WINDOW TO PRINT.
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