Customer Information
Name ______________________________
Address_____________________________
City _______________________________
State _________  Zip Code_____________
Country ____________________________
Phone Number _______________________
Email Address _______________________

Firedrake Steel

P.O. Box 583

Stafford , MO 65757

PLEASE PRINT LEGIBLY
Quantity Item Size Unit Price Total Price
         
         
         
         
         
         
         
         
         
         
 
 
 
 
 
 
Method of Payment
(Circle One)
  • Personal Check
  • Money Order
  • Cashier's Check

Total

MO Residents add 7.225% sales tax

SHIPPING

GRAND TOTAL

Payment (minimum 50%)

BALANCE

ORDERS from ALASKA, HAWAII & outside the Continental U.S.: Please call for shipping arrangements. All international payments must be in U.S. funds only.
-%50 non-refundable down payment required. Balance due within four months. If balance is not received within four months of completion, item becomes property of Firedrake Steel.
PLEASE remember to fill out the measurement chart!


Please make check or money order payable to FireDrake Steel
For Office Use Only: Do Not Write In This Box
Date Received________ Date Completed________ Date Shipped_________