*** 24 hour FAX order line: 503-491-1155 ***
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(Faxed Credit Card Orders Are Accepted)
*** Please Fax or Send By US Mail ****
For non credit card orders - Mail Orders.
Send Check, Money Order, Cashiers Check,Cash Or Credit Card
Make Checks Payable To "RPT Ventures Inc"
Send To:
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RPT Ventures Inc.
PO Box 1697
Gresham, OR 97030
Include: Qty - Item - Description - Price - Shipping (See Rates)
Order Form
Name ___________________________________________________________________
Address _____________________________________________________ Apt# _______
City ___________________________________ State _____________Zip ____________
Shippee Phone (For Federal Express)___________________________
Billing Information: (If same as above, write Same)
Name On Credit Card ______________________________________________________
Billing Address _________________________________________________ Apt# _______
City _____________________________ State ____________Zip ___________
E-Mail (Must Have) _________________________________________________
Billing Phone (Very Important)_________________________________
Authorization : I Certify by my signature that I am 18 years of age &
believe this material to be with the Community Standards of my area.
______________________________ _____________________ Must be signed
Signature Birthdate
Total Order $ _____
Payment - Check ___ Money Order __ Visa __ M/C __ Amex__
Credit # __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ exp ____/____
Signature______________________________________________________
(Required For Credit Card Orders)
*** 24 hour fax order line 503-491-1155 ***
Qty Item Description Amount
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Subtotal $ _______ Shipping (see chart) $ _______ Total $ _______