Needa Manufacturing 4654 Logtown Rd.Lena, WI 54139 (orders-only address) 800-440-8671 / Fax: 920-834-5257 OPEN: Mon-Fri 8 am-5 pm Central Time Print This Order Form...and write in your selections from our Product Listings. Fill in the quantities and purchasing information. See the shipping chart below to calculate your shipping costs. Then, just call in, mail in, or fax in your order!

Charge to: Ship to: Residence   Business Street Address: Street Address**: City: City: State                    Zip State                    Zip Phone: Fax: E-mail: SPECIFY BILLING PREFERENCE: ___Check #_________________ ___P.O. Number_________________ ___Credit Card Order ___Bill an Open Acct (Subject to approval. Include 3 credit references) Credit Terms:  30 Days Custom quotes available for large orders.  Call for details IF BY CREDIT CARD, SPECIFY:       ___ VISA  ___MasterCard Acct No:  __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Expiration Date______________ Print Cardholder's Name ________________________ Cardholder's Address _______________________________ ____________________________________________ CALCULATE YOUR SHIPPING Add the appropriate amount to your order. Up to $15.00 $5.90 $15.01 to $25.00 $7.25 $$25.01 to $45.00 $10.00 $45.01 to $65.00 $13.50 $65.01 to $90.00 $16.00 $90.01 to $125.00 $21.00 $125.01 to $200.00 $26.00 $200.01 & over 20% ** UPS and RPS will not deliver without a street address. All orders shipped UPS Ground unless customer requests other method. Qty Product # Description Price Each Amount Subtotal: $ Sales Tax (WI residents): $ Shipping (see chart): $ Total Price: $ Signature_______________________________________

Home | Company | Product Guide | Contact Us

Needa Mfg. / 4654 Logtown Rd / Lena, WI / 54139 / 800-440-8671 / Fax: 920-834-5257