Alta Photographic Inc. 1421 International Drive, Bartlesville, OK 74006
Phone: 918 / 335-2582 | Fax: 918 / 335-0001 | eMail: info@altaphotographic.com

CUSTOMER ORDER FORM
(If You Are A Current Customer With Open Account, CLICK HERE )
 Ship to:  
   
   
   

 Date  
 Person Placing Order  
 Telephone  
 Visa or MasterCard No.  
 Name as it appears on card  
 Expiration Date  

 QUANTITY

  PART NO.

  DESCRIPTION

  $/UNIT

  TOTAL
         
         
         
         
           
   

  *TOTAL . .

  . . . . . .  
*Actual shipping charges will be added to order total at time of shipping

Please fax completed order form to 918 / 335-0001

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