Contact Information:

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Phone:

Fax:

Cell#:

Email Address *

Ship To Address: (if different than above)

First Name

Last Name

Address 1

Address 2

City

State

Zip

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Quantity and detailed description of products you would like to purchase.

Please check all that apply:

Delivery address is: *

If you are ordering products that already have a delivered price:

If a school or government entity is ordering, you may fax purchase orders to us at 908-637-8421 with a hard copy by mail to:

Partac Peat Corporation, One Kelsey Park, Great Meadows, NJ 07838
If you wish to pay by credit card, please be sure to provide a fax number or email address above, as we will forward a credit card authorization form for you to fill out, sign, and fax back to us.
If you are paying by check, please be sure to provide all necessary information above, so that we can match your check with your order and reach you if we have any questions.

Any further information or questions not covered above?

If you would like to speak to a live person, please call customer service at 800-247-BEAM (2326) from 8:30 AM - 4:30 PM east coast time Monday thru Friday or most Saturdays from 8:30 AM - 12 Noon.

PARTAC PEAT CORPORATION
ONE KELSEY PARK
GREAT MEADOWS, NEW JERSEY 07838
TEL. 908.637.4191
Email: sales@partac.com
FAX 908.637.8421
CALL 800.247.BEAM (2326)