Tyless TM Elastic String
Fax, Mail Order Form
Ship To: Bill To: (If Different)
Name: ___________________________________________ Name: _____________________________________________
Company: _________________________________________ Company: __________________________________________
Address 1: ________________________________________ Address 1: _________________________________________
Address 2: ________________________________________ Address 2: _________________________________________
City: ______________________________________________ City: _______________________________________________
State: _______ Zipcode: __________________________ State: ______ Zipcode: _____________________________
Email Address: ___________________________________ Telephone: __________________________________________
Name: ___________________________________________ Name: _____________________________________________
Company: _________________________________________ Company: __________________________________________
Address 1: ________________________________________ Address 1: _________________________________________
Address 2: ________________________________________ Address 2: _________________________________________
City: ______________________________________________ City: _______________________________________________
State: _______ Zipcode: __________________________ State: ______ Zipcode: _____________________________
Email Address: ___________________________________ Telephone: __________________________________________
If paying by credit card, please provide Credit Card information below. MC, Visa, AMX, Discover accepted
Credit Card Number: _________________________________________________ Credit Card type: ______________
(MC, Visa, AMX, Discover)
Credit Card Expiration Date: _________________________ Fax To Tyless at: 541-344-1579
Amount Authorized: _______________________ Mail to Tyless at: Tyless
P.O. Box 11205
Eugene, OR 97440
Signature: _________________________________________
Orders with personal checks will ship after check
clears bank.
(MC, Visa, AMX, Discover)
Credit Card Expiration Date: _________________________ Fax To Tyless at: 541-344-1579
Amount Authorized: _______________________ Mail to Tyless at: Tyless
P.O. Box 11205
Eugene, OR 97440
Signature: _________________________________________
Orders with personal checks will ship after check
clears bank.
Pricing:
No. of Rolls Price/Roll Shipping Total Delivered Price
1 $21.50 $10.70 $32.20
2 $21.50 $14.50 $57.50
3 $19.50 $14.50 $73.00
Elastic string rolls will be shipped via USPS Priority Mail as
quoted. If you would prefer UPS please contact us for a
quotation. We will also be happy to quote any larger volume
of elastic string you may require.
No. of Rolls Price/Roll Shipping Total Delivered Price
1 $21.50 $10.70 $32.20
2 $21.50 $14.50 $57.50
3 $19.50 $14.50 $73.00
Elastic string rolls will be shipped via USPS Priority Mail as
quoted. If you would prefer UPS please contact us for a
quotation. We will also be happy to quote any larger volume
of elastic string you may require.
No. Of Rolls Price
