Please print out and complete this order form, then mail it along with your check payable to Tele-Ride Binding Company to this address. |
| Name: |
| Street/Apt.: |
| City, State, Zip: |
| Day time phone: |
| Evening phone: |
| Email: |
| Number of items ................................. ______ |
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Items x $89.95 ......................... $______ |
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Assumption of Liability: |
| Your Signature __________________________Date:___________ |