Order Form

ORDER FORM

Please call (785) 273-2657 to verify amount and method of payment.

At this time we are having difficulty processing the Order Form through AOL. Until we get the problem resolved, please send the following information by E-Mail:

Name
E-Mail Address
Street Address
City
State
Zip Code
Evening and Weekend Phone Number
Quantity
Part Number
Part Description

Send e-mail to crcushman@aol.com

Please call (785) 273-2657 to verify amount and method of payment.
updated 2/19/06

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