AKKRA ORDER FORM       

DATE _______________

 Purchase Order # _____________

• We take orders by phone, fax  (please feel free to copy this form to your printer) or email.

• We ask that you  review our policies for shipping and payment.

PRICES ARE SUBJECT TO CHANGE WITHOUT NOTICE.

BILL TO:			SHIP TO: (Please fill out shipping address  form if shipping to a separate address.)
NAME			NAME
COMPANY			COMPANY
ADDRESS			ADDRESS
ADDRESS 2			ADDRESS 2
CITY			CITY
STATE			STATE
POST CODE			POST CODE
COUNTRY			COUNTRY
PHONE:  (           )			PHONE:  (           )
METHOD OF PAYMENT                    CHECK * _____                    OTHER * _____
ITEM NO.	ITEM CODE	QTY	DESCRIPTION	UNIT PRICE	TOTAL
1
2
3
4
5
6
7
8
9
10
TOTAL # ITEMS**_______ Including other order form pages. **(# items, not quantity)  For more than 10 items, please use a second page. Thank you for ordering from Akkra 146 Halstead St, Unit 115 Rochester NY 14610   Fax:1-585-482-7870 Phone:1-585-482-7870 Email:sales@bonefolder.com			subtotal
			Shipping Preference UPS/USPS/Other
			MERCHANDISE TOTAL* *Akkra  will call you for  shipping information.