Petro Mold Co. |
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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 *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)________________________________________
PETRO MOLD COMPANYCUSTOMER INFORMATION SHEETBUSINESS 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.
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