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DICKSON
Step 1 - Bill To:
Name
Company
Address
City
State  Zip
Phone ( ) –
Email
Step 2 - Ship To (if different than above)
Name
Company
Address
City
State  Zip
Phone ( ) –
Email
Step 3 - Ordering Information
Order #  Quantity  Price/Unit    Total
    $  /each  $ 
    $  /each  $ 
    $  /each  $ 
    $   /each  $ 
      Subtotal:  $ 
  In Illinois, add 7.5% sales tax 4 Tax:  $ 
    Freight:  $ 
  All Prices in U.S. Dollars  4  Total:  $ 
Step 4 - Payment Method
  Check: Check #
  Money Order
  Credit Card:
  Credit Card Number: Expires: (mm/yy)
 – – – /
Signature
  Purchase Order: P.O.# (Net 15 days for established customers)
  Customer #:
U.S.A. Freight Charges
Fax to: 1-800-676-0498 Mail to: Dickson, 930 S. Westwood Ave, Addison, IL 60101
Total Order  UPS 2nd Day  UPS Next  UPSGround
$0-100  $17  $35  $11
$101-400  $21  $44  $16
$401-700  $29  $59  $19
$701-1,000  $38  $62  $27
$1,001-1,500  $57  $79  $40
$1,501-2,000  $75  $99  $47
$2,001-over Please call Dickson Customer Service
All shipments UPS 2nd day unless otherwise requested.










