Progress Automatic Door Products Order Form

Name:
Business:
Phone:
Address:
City:	State: Zip:
E-mail:
Payment:	Mastercard Visa Cashiers Check Certified Check Money Order
If paying by credit card, name as it appears on card:
	Card number:
	Expiration Date:
	Address of cardholder:
	City:
	State:
	Zip:

SKU: Description: Qty Amt:
SKU: Description: Qty Amt:
SKU: Description: Qty Amt:
SKU: Description: Qty Amt:
SKU: Description: Qty Amt:
SKU: Description: Qty Amt:
SKU: Description: Qty Amt:
SKU: Description: Qty Amt:

Total:
*Tax:
Shipping & Handling:
**Amount Due:

* North Carolina residents must add 7% Sales & Use Tax
** Entire order must total a minimum of $25.00

Print This Page and FAX to 910-763-4336 Or this form and mail payment to:
Progress Automatic Door, Inc., P.O. Box 12068, Wilmington, North Carolina 28405, U.S.A.