Fax Order Form

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Plug-N-Protect™ Order Form

Step 1 - SHIPPING INFORMATION
Name:
Street Address:
Address (cont.):
City:
State/Province:
Zip/Postal Code:
Country:
email:
phone:

Step 2 - Confirm your Order Quantity

Select Quantity:

Subtotal:

Sales Tax::

Shipping and handling:

Total

Step 3 - Send in your Order

Mail in orders:
Print this form and mail to the address listed below. If you are paying by check or money order, make check/money order payable to:
Light-Rite

Allow five working days for personal checks to clear.

Once your order is approved, it will ship within 24 hours.

You may cut out the following address to use as a mailing label for your envelope.

Light-Rite
Attn: Customer Service
13 Milkwood
Rancho Santa Margarita, CA 92688