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RESCUE_ ME ORDER FORM Date __________________ Name________________________________________________________ Address ______________________________________________________ City ______________________________________________________ State ______________________________________________________ Zip Code __________________ Day Telephone Number ________________________________ Evening Telephone Number ________________________________ E-mail address _________________________________________ RESCUE_ME TOOLS _________ X $_______________ = $______________ Shipping ______________ Ohio Sales Tax ______________ T O T A L $ _____________ .......................................................................................................................................... PAYMENT METHOD: ____VISA ____MasterCard ____ American Express ____ Discover Credit Card# ______________________________________________ Expiration Date _________
Check # _______________ or Money Order # ________________ .......................................................................................................................................... ___ Check if your are interested in
other fire safety equipment, |
