Order Form

Order Information
Phone: (815) 462-9500
Electronically: Fill out the form below and hit <Submit> Temporarily not functioning
Fax: Print this form and fax it to: (815) 462-8955
Mail: Print this form and mail to:
Midwest Laser Products, LLC
P.O. Box 262, Frankfort, IL 60423

Terms & Conditions

Shipping Information
Domestic orders are shipped via DHL ground.  Shipping charges are $8.00. Items weighing over 10 lbs may cost more.  . Foreign orders, please ask for a shipping quote.

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Order Form

Item #

Description

Price

Qty.

Total.

Subtotal.

Tax.

Shipping.

Total.

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Shipping address

Name

Company

    Address

City

State

Zip

Email

Daytime Phone

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NOTE: Orders can only be shipped to the same address that you receive your credit card statement
.
Foreign Orders must be prepaid by international money order, or check drawn on a U.S. bank.

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Payment Information

Cardholder Name

Visa / MC #

Expiration

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