Tatex Thermographers
Online Re-Order Form
Dealer Name
:
*
Account Number
:
*
Invoice Number
of previous order:
*
Ship date
of previous order Date must be entered in this format: ##/##/##):
*
Name
on previous order:
*
Quantity
:
*
Do you have changes?
:
*
Yes
No
If
YES
to changes,
please list below
:
All orders shipped by UPS or Fed Ex Ground
unless otherwise specified in box below.
P.O. Number
(optional)
:
Drop Ship Address
if requesting drop shipment: