| 380 Union Street/P.O. Box 1070 |
| West Springfield, Ma 01090-1070 |
| Fax #: 413-734-9666 |
| Tel #: 413-781-2000 |
| Toll Free #: 800-225-4641 |
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| New Customer: Yes No (circle) | |
| Date:______________P.O. Number:______________ | Attention:_________________________________ |
| Business Name:______________________________ |
Your
Sales Rep
|
| Business Address:____________________________ | Business Contact:__________________________ |
| Phone #:_____________________________________ |
Name
of Person
|
| Fax #:_______________________________________ | Placing the Order:__________________________ |
| E-mail:_______________________________________ | |
| BILL TO: | SHIP TO (if different from Bill To): |
| Name of Business:____________________________ | Name of Bussiness:________________________ |
| Street Address:_______________________________ | Street Address:____________________________ |
| City:________________________________________ | City:_____________________________________ |
| State:______________________ Zip:______________ | State:________________ Zip:________________ |
| Please Make Additional Photocopies Of Blank Form for Future Use |
| Description | Item Size/Color | Order Qty. | Unit | Price | Line $ Total | |
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| 10 |
INDICATE
YOUR METOD OF PAYMENT Exp.
Date:__________
|
Contact us at: cs@partyworld.net or 413-781-6311 for further assistance. Fax your order to Party World and other things...Fax# 413-734-9666. Visit us at www.partyworld.net for questions call Toll Free 1-800-225-4641! |
| ____________________________________________________ |
Number
of pages transmittedincluding this sheet:__________
|
| Authorized Signature (as shown on credit card) |