Mail Order Form

Telephone orders: (603)668-8186
Fax Orders: (603)668-1783

Mail orders: Solar Components Corporation, 121 Valley Street, Manchester NH 03103 USA


Bill to Address
 
 
      Name_________________________________________________________
 
      Street_______________________________________________________
 
      City_________________________________________________________
 
      State & Zip__________________________________________________
 
      Country______________________________________________________
 
      Telephone____________________________________________________
 


Ship to Address
 
      Name_________________________________________________________
 
      Street_______________________________________________________
 
      City_________________________________________________________
 
      State & Zip__________________________________________________
 
      Country______________________________________________________
 
      Telephone____________________________________________________
 
 
                 
                For "C" items call for freight quote
                                              
                  
       
 Products ordered
 
 
  Part No.   Qty.           Description               Unit Price       Total
 
      _________________________________________________ $______________$__________
 
      _________________________________________________ $______________$__________
 
      _________________________________________________ $______________$__________
 
      _________________________________________________ $______________$__________
 
      _________________________________________________ $______________$__________
 
      _________________________________________________ $______________$__________
 
      _________________________________________________ $______________$__________
 
      _________________________________________________ $______________$__________
 
      _________________________________________________ $______________$__________
 
      _________________________________________________ $______________$__________
 
      _________________________________________________ $______________$__________
     
      _________________________________________________ $______________$__________
                                                                                   
                                              Shipping (check with shopping cart for shipping cost)  $__________
 
 
                                                                                                                            Total  $__________
 
 

 

Method of payment

 
Total payment
of $___________ enclosed. (Total payment is sum
 of products ordered + shipping and handling.)
 
? Mastercard  ? Visa  ? Amex  ? Discover
 
 Credit Card No._____________________________________________________
 
 Expiration Date_____________________________________________________
 
 Cardholder Signature________________________________________________
 
CVV Number on back of card__________________________________________


  
Office Hours
 
Mon-Fri: 8:00 am - 5:00 pm EST,
Tel.(603)668-8186  Fax.(603)668-1783