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You May Use This Form To Place Orders Through This Website With TEC Communications Distributors. Once Your Account Is Setup, Active, And You Have Received Our Complete Price List With Part Numbers Or If You Are Now A Current Dealer You May Go Ahead And Place Your Accessory Order With Part Numbers Or Product Description. When Finished Filling Out This Form Completely. Please Click The Submit Button And Your Order Will Be Automatically Sent To Our Warehouse For Order Completion. If You Have Any Questions Or Problems Please Contact us at 785-543-2121. ( IF YOU CURRENTLY DO NOT HAVE AN ACCOUNT SET UP WITH OUR COMPANY, AND WANT TO PLACE AND ACCESSORY ORDER PLEASE CONTACT OUR SALES DEPARTMENT AT 785-543-2121. )
| Account # | |
| Name | |
| Business Name | |
| Street Address | |
| Address (cont.) | |
| City | |
| State/Province | |
| Zip/Postal Code | |
| Country | |
| Work Phone | |
| FAX | |
Please provide the following ordering information:
| QTY | PART # or DESCRIPTION |
| BILLING | |
| Purchase Order # | |
| Account Name |
| SHIPPING INFORMATION | |
| Street Address | |
| Address (cont.) | |
| City | |
| State/Province | |
| Zip/Postal Code | |
| Country |
SHIPMENT METHOD: ( PLEASE SELECT )
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