Proctor Enterprises

35900 Industrial Way, Suite 401 Sandy, OR  97055  USA

Phone: (503) 651-1918         Fax: (503) 826-1918

sales@proctor-enterprises.com

Order Blank

Print this order blank through your internet browser, then fill it out and fax or mail it to us, along with your payment to our address listed above.

Name                                                                                          Date                                             
Address                                                                                      Phone                                          
City, State, Zip                                                                                                                            
Part # Description Qty Price Ea. Subtotal
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             

Handling, Shipping, & Insurance (Click here for rates & information):

   

Total:

   

Payment type:  

(Please check one)   

Money Order               Check              Discover        
Visa              Mastercard               American Express        
Credit Card #                                                                            Expires (mm/yyyy)