Order Form/Hand Delivery Form

To pay with a Personal Check, Cashier's Check or Money Order please fill out this form, print and include with payment. Be sure to keep a copy for your records.

Please make checks payable to :Jose A Sanchez
                                                     P.O. BOX  940443
                                                     Miami, FL 33194-0443

Please provide the following contact information:

First Name
Last Name
Middle Initial
Title
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail

Please provide the following product information:

Product Name

Please provide the following ordering information:

QTY DESCRIPTION

SHIPPING
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

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