Order Date

Date

Order Type

Delivery Pick-Up

Client's Name

First Name Last Name

Email Address

example@example.com

Phone Number

Office/Company Name

Department

Delivery Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Products

Notebook

$1.00 Quantity

Pencil case

$2.00 Quantity

Scissors

$3.00 Quantity

Ruler

$2.00 Quantity

Glue Sticks

$3.00 Quantity

Glue Gun

$5.00 Quantity

Glue

$2.50 Quantity

Pencils

$1.50 Quantity

Ballpen

$2.00 Quantity

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Payment Method

Remarks/Special instructions

REMINDERS We'll contact you within 24-48 hours to confirm your order. Kindly review the autoresponder email that you receive to make sure that the order is correct. It is recommended not to order supplies for more than 30 days because of the temperature. These supplies will be delivered or picked-up using boxes. If you have any questions, please contact us at (123) 1234567 or email us at orders@abcsupply.com.

Supply Request Form