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

ORDER FORM: CURRENT CUSTOMERS WITH OPEN ACCOUNTS
(If You Do Not Have An Account, CLICK HERE )

 P.O. Number:

 Ship to:  
   
   
   
 Bill to:  
   

 Date  
 Person Placing Order  
 Telephone  
 How to Ship  
 When to Ship  
 Air Acct. No.  

 QUANTITY

 PART NO.

 DESCRIPTION

 $/UNIT

 TOTAL
         
         
         
         
    01-99999-99-01   SHIPPING*    
   

  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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