logo-art-240x160.jpgYour small, hometown-attitude company
Keith Specialty Store
6791 Rt 119 Hwy N,  Marion Center, PA 15759
US callers: 800-705-8838
FAX: 724-397-2228
Outside the US: 724-397-8838
8:00am-6:00pm  M-F, 8:00am-3:00pm Sat. (ET)


Order Form

Keith Specialty Store:  Fax: +1 724.397-2228  Voice: +1 800.705-8838

keithspecialty.com printable order form.  Please print very clearly.

Name: Date:
Shipping address:

 

 


[  ]Residential    [  ]Business

Billing address (if different):

 

 

Email: Day phone: Fax:
Payment by: [_]VISA  [_]MasterCard  [_]Discover   [_]American Express  [_]PayPal   [_]Money order   [_]Check (allow 2 weeks)
Credit Card# ______________________________________   Exp. Date:_______/_________ CCV/CID __________
Name on card: _____________________________________   Signature: ___________________________________
Shipping Method: [  ]UPS Ground   [  ]UPS 3-Day Select   [  ]UPS 2nd day air   [  ]UPS Next Day Air   [  ]USPS Priority Mail
             [  ]UPS Express Canada   [  ]UPS Expedited Canada   [  ]UPS Standard Canada (ground service)   [  ]Pick up at Keith's
Qty Item # Description Cost ea. Total
                       
           
           
           
           
           
           
           
           
           
           
           
           
Product subtotal   
shipping charge*   
Subtotal   
Pennsylvania residents add 6% sales tax   
Total   
*To get shipping charges, put the items into the shopping cart and plug in you ZIP code.
Keith Specialty Store, 6791 Route 119 Hwy N, Marion Center, PA 15759  
Fax: +1 724.397-2228   Voice: +1 800.705-8838