Rays Mart - Mail/Fax Order Form

Fax / Mail Order Form For Raysmart
(586) 979-7399 Fax number

Print this page and use it as an order form
*personal checks are held for 10 days before shipping

Quantity	Model #	Description	Price	Total
________	__________	________________________	_______	_______
________	__________	________________________	_______	_______
________	__________	________________________	_______	_______
________	__________	________________________	_______	_______
________	__________	________________________	_______	_______
________	__________	________________________	_______	_______
________	__________	________________________	_______	_______
		Merchandise Total		_______
		Shipping - no charge on orders over 50.00 / email for amount on smaller orders		_______
		Insurance *add 1.50 per 100.00 optional**		_______
		ORDER TOTAL		_______

Money Order	Personal Check
BILL TO:		SHIP TO:	If different from Billing Info
Name	______________________	Name	______________________
Address	______________________	Address	______________________
City	______________________		______________________
State / Zip	________ ______		______________________
Home Phone	______________________		______________________
Fax	______________________		______________________
E-mail	______________________		______________________






Paying by:	(circle one)
VISA	DISCOVER	MASTERCARD	American Express
Card #	______-______-_____-_____	Expires	_____/____/____

Rays Mart
237 North River Dr.
Mt. Clemens, MI 48043
(810) 954-1391
(810) 979-7399 fax

Located inside the
Gibraltar Trade Center
Fri. 12-9 Sat 10-8 Sunday 10-6
weekdays by appointment only