Van de Sande Industries, Inc.
Post Office Box 1104 · Cardiff by the Sea · California · 92007 · USA · Web Site: http://www.bartendergear.com
Website Order Form	Bartender Gearä & SpeedGuardä Catalog Order Form		It’s Easy to Order!
EMAIL YOUR ORDER	PHONE YOUR ORDER	FAX YOUR ORDER	MAIL YOUR ORDER
Email us with your desired items & we’ll email back with	Phone your order to:	Fax this form to:	Mail this form to:
an exact quote and payment information.	(415) 377-3438	(760) 268-0953	PO Box 1104
Send order to: sales@bartendergear.com	10 am – 4 pm PST	Attn: Sales Dept.	Cardiff, CA 92007

ORDERED BY

Company Name

Name

Address (1)

Address (2)

City, State, Zip

Phone, Fax

E-mail Address

SHIP TO

Name

Address (1)

Address (2)

City, State, Zip

Country

Phone, Fax

E-mail Address

Type of Business

INDICATE METHOD OF PAYMENT

Check amount

Money order amount

Credit Card Number

Name on card

Security # on back of CC

Expiration Date

Signature

SHIPPING INFORMATION

Within California, please add sales tax.

Shipping via UPS or other carrier:

Check Shipment pricing at:http://www.speedguard.com/shipping.htm

Or contact us for the exact shipping charges.

Or Use Our Secure Shopping Cart Via the Internet at: http://www.bartendergear.com
ITEM NO.	QTY.	ITEM NAME		PRICE	TOTAL
				SUBTOTAL
		California Sales Tax		add 7.75%
		SHIPPING & HANDLING
			TOTAL COST