Order Form for Customers

Personal Information
Your Name:	*
Title:	*

Company Information
Company Name:	*
Plant Location	* *(Enter plant number or street address)*
E-mail Address:	*
PS&E Customer Number:	If any company information has changed, please enter the new information below, so we may update our files. If you are an existing customer and your billing and shipping information have not changed, click here to skip to the Order Information section.
Telephone:	Ext.
Fax:

Billing Information
Address Line 1:
Address Line 2:
City/State/Zip Code:
Country:

Shipping Information (If same as Billing Information, enter "SAME".)
Address Line 1:	(or "SAME")
Address Line 2:
City/State/Zip Code:
Country:
Ship To The Attention Of:

Order Information

Purchase Order Number:

*
(Enter P.O. Number or "verbal" if not required.)

For part numbers and pricing, see our hardcopy catalog, cd-rom catalog or current sales flyer.

Payment Method: *(Select one)* *	Bill Our Account Certified C.O.D. (Cashier's Check) Credit Card *(If your credit card is not already on file, please call PS&E at 1-800-627-1033 to provide credit card information.*
Shipping Method: *(Select one)* *	Specify See UPS Delivery Schedule for estimated lead times.

Your Next Barrel or Screw Is Probably On Our Shelf...
Call Today To Check Our Inventory!

PS&E Order Form