2846 Farnsworth Rd.
Lapeer, MI. 48446
Toll Free 1-887-816-2294
Fax 1-810-245-0098

 Back to Web Site: 

Future Technology Services , INC.

Please fill out the following Shipping and Ordering form then print it:

Today's Date: 

PERSONAL INFORMATION:
Your Name:
Address1:
Address2:
City:
State:
Zip Code:
Day Phone: Ext:
Home Phone:
E-Mail:
 

Check if information is the same as Personal:
BILLING INFORMATION:
Billing Name:
Address1:
Address2:
City:
State:
Zip Code:
Day Phone: Ext:
Home Phone:
E-Mail:
 

Check if information is the same as Personal:
SHIPPING INFORMATION:
Shipping Name:
Address1:
Address2:
City:
State:
Zip Code:
Day Phone: Ext:
Home Phone:
E-Mail:
 

 
Previous Customer    Yes    No 
How Did You Hear About Us 

 
METHOD OF PAYMENT:
Bill Me:
Cash:
Money Order:
Check:
Purchase Order:
Purchase Order Number:
Purchasing Agent:
Accounts Payable Contact Name: