ORDER FORM

Fax or Mail To:

Asphalt Press Industries
P.O. Box 10
Oaks, PA 19456

Fax: 1-800-728-3779

 

Please Print Clearly
Company Name ___________________________________________________________________
Street Address ____________________________________________________________________
City ____________________________________________________ State ________
Zip ________
Tel. (______)______________________________
Fax (______)______________________________

Signature _________________________________________________
Date ___________________
Print Name __________________________________
Email ________________________________

 

BOOKLET PRICE GUIDE
 Quantity @ Price for Each = Your Price Quantity @ Price for Each = Your Price
          25 @ 2.35 ea. = $ 58.75      200   @ 1.95 ea. = $390.00
          50 @ 2.25 ea. = $ 112.50      300   @ 1.85 ea. = $555.00
        100 @ 2.10 ea. = $210.00      400   @ 1.75 ea. = $700.00
        150 @ 2.00 ea. = $300.00      500+ @ 1.65 ea. = $825.00

SUPER GLOVE PRICE GUIDE

Quantity @ Price for Each = Your Price

          06 @ 3.95 ea. = $ 23.70          30 @ 3.55 ea. = $106.50
          10 @ 3.75 ea. = $ 37.50          40 @ 3.55 ea. = $142.00
          20 @ 3.55 ea. = $ 71.00          50 @ 3.45 ea. = $172.50

 

 

 

 

 

QUANTITY

ITEM

YOUR PRICE

  DRIVEWAY BOOKLETS$                    .
  BROWN KRAFT ENVELOPES
 Quantity x 15c = YOUR PRICE		$                    .
  SUPER GLOVE - large$                    .
  SUPER GLOVE - extra large$                    .
  SUPER SHOVEL - long handle
 Quantity x $29.95 = YOUR PRICE		$                    .

Shipping & Handling   

$                  10.00

Total   

$                    .

  VISA   MC   DISCOVER   AMERICAN EXPRESS

  ACC #     __ __ __ __    __ __ __ __    __ __ __ __    __ __ __ __

  Exp. __ __ /__ __   Cardholder Name (print): __________________________

* Your check or credit card # must accompany order, We Do Not Invoice
* For speedy delivery, all shipments are delivered by UPS
* We guarantee our booklets will give you 100% satisfaction in every way. If you are not 100% satisfied with the merchandise, you may return any unused booklets within 30 days for a prompt refund. No Questions Asked!