Petro Mold Co.

Just Print these forms and mail or fax them to us.  It's easy! In order to become a Petro Mold Dealer, simply purchase a minimum of 3 building molds or any combination of molds that exceeds $150.00 after all applicable discounts.  All village specials qualify for minimum building purchase.

AutoShip Dealer Plan
Petro Mold Co.  - 12775 Donation Road,  Waterford, PA  16441 – 888-811-6653

Becoming an AutoShip Dealer with Petro Mold Co. gives you the unique opportunity to have all of the privileges of a Distributor without the mandatory quantity requirements.  As an AutoShip Dealer, you will automatically receive a minimum of one (1) mold a month of your choice, and receive a full 50% off of the suggested retail price.*  We just bill it to your credit card and ship it out to you.  As long as you remain an AutoShip dealer in good standing, all molds you purchase from Petro Mold Company will qualify for the 50% discount.    

*Monthly mold selections need to have a combined retail value exceeding $50.00 ($25.00 wholesale).

YES! Sign me up for the AutoShip Plan with Petro Molds to save 50% off on every mold I purchase.  I authorize Petro Mold Co. to bill my credit card for every sale under this plan and I understand that I must have a valid credit card and PA sales tax information on file to receive my molds free from 6% Pennsylvania sales tax.  By signing below, I agree to purchase a minimum of one mold a month  (plus freight charges) at a combined retail value of $50.00 ($25.00 wholesale).  I understand that I can cancel my membership after I purchase a minimum of six (6) additional molds.   If I default under this agreement, my AutoShip status with Petro Mold Company will terminate.  To reactivate, I will need to restart the program from the beginning according to the terms in effect at that time. 

Signed ______________________________ Print Name______________________________Date ____________

Company Name (please print)________________________________________
Effective 1/1/05

PETRO MOLD COMPANY

CUSTOMER INFORMATION SHEET

BUSINESS INFORMATION:

BUSINESS NAME: _______________________________

SHIPPING ADDRESS:_____________________________

CITY:___________________STATE:_____ZIP:_________

PHONE NUMBER:_________________________________

FAX NUMBER:___________________________________

E-MAIL ADDRESS:________________________________

CREDIT CARD INFORMATION:

CARDHOLDER’S NAME:____________________________

BILLING ADDRESS:______________________________

CITY:___________________STATE:_____ZIP:________

CREDIT CARD NUMBER:___________________________

EXPIRATION DATE:______________  TYPE:  MC  VS  DC

V-CODE ON CREDIT CARD:_________________________ (LAST 3 DIGITS IN WHITE STRIPE ON BACK OF CARD)

TAX EXEMPTION NUMBER:_________________________ STATE:__________

CONTACT PERSON FOR SHIPMENTS:_________________

WHAT IS THE BEST WAY TO REACH YOU DURING BUSINESS HOURS?  TELEPHONE  / E-MAIL / OTHER _____________________

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Contact Us Toll Free - US / Canada:  888-811-6653

Send email to petro@velocity.net with questions or comments about this web site.
Copyright © 1996-2008  W. Robert Petro Studios, Petro Mold Co.
Last modified: September 02, 2008