Rt 66 Restoration Supplies
201 West Main
Stroud, OK 74079
Phone
(918)968-2366 Fax (918)968-1955
Home
Print order form to fax or
mail.
To email, copy and paste form below to email message body then fill in
information.
Place email order
Shipping fee is based on UPS ship fees and will be
figured when order is packaged.
| ....................... | ......................... | ............Tell us about your car....................... | --------------------- |
| Year | Doors | Series & Body Style | V8 or 6Cyl |
Shipping Information: |
|
| Name | |
| Street Address | |
| City, State, Zip | |
| Phone # | |
| UPS Options | Ground_____ Next Day Air_____2nd Day Air_____3rd Day Air____ |
| Pay Method................ | ............... | ........................................ |
| MasterCard | Visa | C.O.D($8.50 fee) |
| ............................................Card Information............................... | |
| Card # | Exp Date |
| If emailing: email the last 4 numbers in a seperate email for safety |
| Quantity | Part #.......... | Description.................................................................... | Unit Price....... | Total............... |