Superior Pad Outfitters
6295 Foley Lane, Central Point, OR  97502-9606  |  Toll Free: 888-855-7237  |  Fax: 541-855-2385
Email: customerservice@superiorpads.com  |  Website:  http://www.superiorpads.com

Complete Order Form and mail to above address.  Please print clearly.
All orders MUST be prepaid before orders are shipped, unless using a PO#.  Thank you for shopping with us.


BILL TO:


SHIP TO:
ADDRESS:


ADDRESS:




PHONE #:


PHONE #:
FAX #:


FAX #:
Credit Card #


Expiration Date:
Name on Credit Card:


Purchase Order #
Check/Cashier's Check #


Money Order #:
QTY
ITEM NO.
DESCRIPTION
PRICE EA
TOTAL















































Subtotal





Call or email for shipping charge.

Shipping







Payment Enclosed

     
If you need to add more items, please use other side, then mail completed Order Form (and Payment) to the above address.  If using a credit card or PO#, please fax to above number.