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  THE TIRE CHAINS SPECIALIST                        814-248-3375

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OFF-LINE ORDER FORM

Please print this page and fill it out.  Then fax or mail your order to us.  You can also call your order into us.  For faster and safer service, use our secure severs @ www.tirechain.com. 

tirechains.com
313 Main Street
South Fork, PA  15956

Phone: 814-248-3375
           814-495-4177

Fax: (814) 495-4526
email:  sales@tirechain.com
www.tirechain.com
Today's Date:
P.O. #
(if applicable)
Sold to (name & address):
 
Ship to (if different than sold to):
 
Product # Description Tire Size Quantity Price per unit Total
           
           
           
           
           
           
           
           
           
           

 Subtotal:

PA  Residents add 6% Sales Tax:

Shipping Charges (please call):

TOTAL:
 
 
 
 
Money Order
Name on Card:
Credit Card #
Expires:
Signature:
Phone Number
 
 
 
 
 
Check #:
 

Credit Card (form to right):
 
Worried about your information security when ordering
 Online? All transactions conducted on our sites are
 encrypted using the latest in secure server technology.

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