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| 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:______________ Name On Card:_________________________ ALL ORDERS ARE FOB DALE, INDIANA. OFFICE USE ONLY Customer No.:_________________ Authorization:________________ Order Date:___________________ Ship Date:____________________ |