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Mail-In Order Form

Most orders can be completed using the "Shopping Cart" feature available on each page. Please use the "Shopping Cart" feature if you can.

If you have a problem using the "Shopping Cart" feature for credit card processing, you can just fill up your shopping cart and while looking at the "Shopping Cart" page, print it, mail it in with a check and the following form for shipping information.

We have provided this form just in case. Because of mass amounts of spam email the direct emailing function had to be removed. You can send an email to Sales Information with any questions, orders or other requests.

Placing a "Mail-In" Order

Use this form if you can not complete an order with our Shopping Cart.

Fill out the form on line and "Print It" on your printer. You can also print this page out and fill it in by hand if you prefer. You should keep a copy for yourself.

Make Money Order payable to:
  Jerry W. Freeman
  1138 Normandy Dr.
  Portsmouth, OH 45662

Send the printed form to:
  Jerry W. Freeman
  1138 Normandy Dr.
  Portsmouth, OH 45662

You can use the Shopping Cart on our website to find Shipping Costs and Ohio State Tax Amount.

(Ohio State Tax must be collected if shipment delivery address is in Ohio. )
-Indicates a required item for shipments.

Discounts only apply to merchandise. Shipping and Sales Taxes can't be discounted.

Our Privacy Statement about our use of information collected here may be viewed on our Privacy Notice page.

Your Name:-

E-mail Address:-

Home Address:-

Apt. or Suite:-


State, Zip:-

(Area Code) Telephone:-

List items and prices here:

-Discount: (merchandise only)

Ohio State Tax:

Shipping Costs:

Total Costs:

Please add any comments, shipping information
or questions you may have.

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Modified: 10/27/17 2:34 PM