ON-LINE ORDERING

To place orders, please fill out and submit this form.  You will receive a call, fax, and/or e-mail to confirm your request.  Thank you for the opportunity to serve you.

 

You may fax your order(s) as well.  Make sure to include the same information below and we'll call you upon receipt to confirm your request.

Your order will be active upon confirmation from our staff.  If for any reason you feel that you have not received timely confirmation, please feel free to contact us by phone.

** Fields accompanied with double asterisks (**)are required for submission **

 

Print and Fax our PDF Order Form. Click the PDF Icon below.

PRINT/E-MAIL PDF ORDER

 


YOUR INFORMATION

**ACCOUNT:
**REFERENCE:
**NAME(LAST):
**NAME(FIRST):
TITLE/POSITION:
ORGANIZATION:
**PHONE:
FAX:
E-MAIL:

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PICKUP

**READY TIME:
**MONTH:
**DAY:
**YEAR:
**ADDRESS:
DEPARTMENT:
**CITY:
**STATE:
**ZIP CODE:
**PHONE:
ALT PHONE OR EXTENSION:
SPECIAL INSTRUCTIONS:

DELIVERY

**DEL BY TIME:
**MONTH:
**DAY:
**YEAR:
**ADDRESS:
DEPARTMENT:
**CITY:
**STATE:
**ZIP CODE:
**PHONE:
ALT PHONE OR EXTENSION:

SPECIAL INSTRUCTIONS:

REQUEST CONFIRMATION OF ORDER-PLACED BY:

PHONE

FAX

E-MAIL

REQUEST PROOF OF DELIVERY(POD) BY:

PHONE

FAX

E-MAIL

CLICK HERE TO SUBMIT
CLICK HERE TO PRINT

For an immediate response, please call to speak with our friendly order-entry specialists who are available to help you 24-hours a day.

TOLL FREE: (800) 278-0452
FAX: (877) 251-6533



A-LINE MESSENGER SERVICE - 2 - DELIVER - 4 - YOU!