Sandown Wireless ROHN Products Order Form

                                          19 Phillipswood Road, Sandown NH 03873

                 Questions? Leave us your contact info: 603-425-9876 or (Recommended) E-mail Us

   Adobe Version             Please Print Clearly, All Required Information           Word Version

              Sold To: (credit Card Billing Address)                                         Ship To: (Final Destination)

Name: ________________________________________  Name: ________________________________________

Address: _______________________________________  Address: _______________________________________

City: __________________State: ____ Zip:___________  City: ___________________State: ____Zip:__________

Telephone: __________________________ Fax: _______________________ e-mail: ________________________

Check Enclosed  ____    Money Order Enclosed ____     Credit Card Order ____

Purchase Order Number: (______________)  Master Card: ___  Visa: ___  Discover: ___

Card Number: _______________________________________________________________

(Note: We can contact you in the evening for CC info if you do not want to list that info on this form)

Exp. Date: _________Sec. Code:_________ Name On Card: ___________________________

Signature (Required if using Credit Card) ________________________________________

Returns: Full Refund Offered for 30 days if not satisfied with Supplied Products. Items must be

Returned as new, unused parts. We will make every effort to supply the correct parts for your use.

*Please Supply Exact ROHN Products LLC Part Numbers. Contact by E-mail for Parts ID Help.

                       Please Contact Sales to get your Freight Quotation. (Sales)

Qty-----*Part Number-----------------Description------------------------------Price Each----Item Total

____    ______________   ___________________________________  _________  ___________

____    ______________   ___________________________________  _________  ___________

____    ______________   ___________________________________  _________  ___________


Qty-----*Part Number-----------------Description------------------------------Price Each----Item Total

____    ______________   ___________________________________  _________  ___________

____   ______________   ___________________________________   _________   ___________

____   ______________   ___________________________________   _________   ___________

                                  (Use a separate Sheet if you have a long list of parts required)

 Sub Total Material Cost: $________________ Quoted Shipping Charges: $_________________

                                     Order Total: __________________ U.S. Dollars

                                                             Shipping Information:

Some items are UPS shippable but most require that a Trucking quotation be given. Please Contact Sales

for a shipping quotation to your site. There is no minimum order size and we can arrange shipping worldwide.

There is no on-line ordering as experience has shown us that we need to supply you with all documents and

a full quotation before you order. This avoids having to return very expensive to ship steel.

                                            E-Mail, or Mail This Form To: (Sales)

Sandown Wireless, 19 Phillipswood Road, Sandown NH 03873

To Contact Sales, Call our office at: 603-425-9876, leave a message. We will respond ASAP.

                                  Our Preferred Contact Method is E-mail: (Sales) 

Personal Information will not be given to anyone else for any reason. Every effort is made to protect

The privacy of our customers. That is why we ask that you mail or E-mail  this information. Never

give Credit Card information to unsecured Internet servers.  Tower Parts Order are Prepaid so your

Credit Card will note a charge when you place your order. If you would like us to contact you for CC info over

 the phone, just make a note on the form where it asks for the CC info.

 Micro                                     Thank You For Considering Us - Sandown Wireless - USA