Fax Order Form


Fax Order Form (Please print this form and complete all necessary sections)
MINIMUM MERCHANDISE ORDER REQUIREMENT IS $50.00.
To: Alpha Store Fixtures, Inc.	Date:	_____________________________
Fax: 205.833.1881	Sender:	_____________________________
Attn: Sales	Organization:	_____________________________
	Phone:	_____________________________
	Fax:	_____________________________

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Order	Quote Request	Info Request	Other
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to place an order for fixtures, please provide the following required information:

Full Name:	________________________________________________________
Street Address:	________________________________________________________
Address 2:	________________________________________________________
Please indicate if the address you have provided is a residence address. YES NO (circle one)
City:	________________________________________________________
State/Province:	_____________________________
Zip/Postal Code:	_____________________________
Contact Name:	_____________________________
Day Phone:	(_____) ______________________
Email Address:	________________________________________________________

SKU #	Description	Qty	Price Ea.	Total Price












SUBTOTAL:				$
SHADED AREA FOR IN HOUSE USE ONLY - DO NOT COMPLETE (We will calculate appropriate shipping, freight and AL tax, when applicable, and notify you of the total cost of your order.)
Shipping/Freight:
AL Tax (if applicable)
TOTAL:				$

Please review your order prior to faxing to insure the accuracy of the information you have provided.

Upon receipt of your completed fax order form, we will contact you at the day time phone number given above to:

Confirm your order and advise you of product availability;
Answer any questions you may have;
Arrange for payment and shipment of your order.
Fax orders must be signed by a person authorized to make such requisitions either individually or acting on behalf of a company or organization.

If you are interested in obtaining a quote or other information, please enter your request here:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

______________________________________
Authorized By Signature

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This fax communication is intended only for the use of the addressee and may contain information which is privileged and confidential. If you are not the intended recipient, you are hereby notified any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by telephone, and return the original to us by mail. Thank you.