Order Form

At dar-tech, inc., we thrive on making you, the customer, our number one priority. 

We offer total customer satisfaction with our one-stop solution to accommodate your needs with effective and timely distribution and exceptionally trained personnel.
 Please fill out the form below to place an order.  If you would like to place an order using  American Express, VISA or MasterCard, please call  1-800-228-7347.
 

Bill to Address:

Name

Company

Address

P.O. Box

City

State

Zip

E-mail

Phone

Fax

Ship to Address:

Same as Bill to Address?  

  Yes

   No

Name

Company

Address

P.O. No.

City

State

Zip

Shipped via

Date needed

 

Quantity

Container

Product

Product Code

Price/lb.

 

dar-tech, inc.
16485 Rockside Road, Cleveland, Ohio 44137
800-228-7347