Pro Staff Order Form

Personal Information

First Name *

Last Name *

Email Address *

Daytime Phone *

Shipping Address *

City *

State *

Zip Code *

Employer Information

Company Name *

Store # (if applicable)

Address

Email Address

Phone Number

Product(s) Being Purchased

Model Number & Quantity *

Signature Required *

Yes

No

Payment will be taken when your order is entered. We accept VISA, MasterCard, American Express or Discover. Please provide the best phone number to ensure prompt payment and delivery. Discount does not apply to blemished products. Shipping charges and Sales Tax will be added to your order.

Thank you for your business! Your submission has been successfully sent to the B&T Team. We will review and contact you with in 1 - 5 business days for payment and order verification.

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Personal Information

Employer Information

Product(s) Being Purchased

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B&T Industries, LLC

SHOP

RESOURCES

SUPPORT

1 (316) 721 – 3222

Mon-Fri 8:00-4:30 CST

CAGE CODE 3L7F2