Order

Print – Fill Out – Scan & Email to cs@containerslik.com

Customer Name:_____________________________________________

Address:____________________________________________________

City:_________________________________State:__________________

Zip:_________________

Phone:________________________

Size Of Slik (TG,#2,#3,True): _______

Qty (In Cases):________________

Total (Use Volume Case Prices): ______________________

Freight: ______________________

Grand Total: __________________

Payment Method

Company Check: Order will be processed when we receive payment.

Credit Card (Visa, Mastercard): _________________________________________

Card No.:___________________________________________________________

Expiration Date:_______________________  Security Code: __________________

Name On Card:______________________________________________________

ALL ORDERS ARE FOB DALE, INDIANA.

OFFICE USE ONLY

Customer No.:______________________________________________________

Authorization:______________________________________________________

Order Date:______________________  /  Ship Date:_______________________