Phoenix Tape & Supply Co      Phone: 803-788-3184 - Fax: 803-736-0106 - Columbia, S.C.

  SECURE - ON LINE ORDER FORM               

If you would like to place an order for any of our items please fill out the information below and click the submit button at the bottom of this form.  Please be sure to list your Email Address below.

>>>Information shown in red are required fields. <<<
Your Name
Company Name
Mailing address
Shipping address
City
State Zip Code
Work Phone
Other Phone  
FAX
E-MAIL Please be sure to list your Email Address
BILLING INFORMATION
The information below must be exact match as on the Credit Card
Credit card
Cardholder name

Card  number

Expiration date
CVC Code   Code on Back of Card Visa/Mcrd  -  Or Front on Amex
Billing address (Same as on Credit Card) 
City (Same as on Credit Card) 
State Zip Code (Same as on Credit Card) 
   
Qty Item # DESCRIPTION Price Quoted
Importance Of  This Request
  PLEASE LIST ANY COMMENTS BELOW:
  
Note:  If you want a reply or confirmation by email, please list your email address in comment box or at the top where it ask for your email! 
Thank you for visiting with us at Phoenix Tape. Please visit with us again.
Now hit SUBMIT Button Below, Click only Once, it may take a from 10 to 30 seconds for submission depending on your connection to the internet.