Order Form

Print and use this form when ordering by mail or fax. You may also use this form for quotations.

Venture Marketing Group LLC
647 Port Sheldon ... Grandville, Mi. 49418
(616) 457-5847 fax

Ship to : Name: _________________________________________________________
Address: ______________________________________________________________
City: _________________________________________ State: _____ Zip: __________
Telephone: __________________________ Fax: ______________________________
E-mail Address: _________________________________________________________
Method of Payment: Money Order, VISA, Master Card, AMEX ( circle one )
Credit Card Number: ____________________________________ Exp. Date: ___
Name on Card: _________________________________________________________
Card Address: _________________________________________________________
City: __________________________________________ State: _____ Zip: _________
Telephone: _________________________ Fax: _______________________________
Authorized Signature: _______________________________________ Date _________

QTY	-- ITEM NUMBER --	---------- DESCRIPTION ----------	--- EACH ---	---- TOTAL ----
.	.	.	.	.
.	.	.	.	.
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			-- Sub-Total	.
		Michigan Residents Add 6 % Sales Tax	-- Sales Tax	.
		Shipping Weight -	-- Shipping	.
			-- TOTAL	.

Sorry no Personal/Business Checks or COD's.

Customer credit cards will be billed as Venture Marketing Group LLC.