Order Form
This Order Form gives the Web Customer a way to send basic order information via email. We prefer to have orders phoned in. See the Placing Orders page. Customers need to complete the following fields in the Customer Information Area. Name, At least 1 Phone Number, and a shipping address. Do not send financial information in this form. The form will send information via normal unsecured email. We will acquire the financial information in a followup phone call. Reeffarmers currently accepts paypal, visa and mc payments. Customers can list the items they are interested in purchasing within the Order Comments form section or just type 'call me for order'.

BASIC CUSTOMER INFORMATION

NAME:
E-MAIL ADDRESS:
SHIPPING ADDRESS :
CITY,STATE,ZIP:
DAYTIME PHONE: FAX PHONE:
EVENING PHONE:
ORDER COMMENTS:

After completing the form fields above you must select Send located below to email the information to a ReefFarmers.com sales representative.



If your browser dosent support forms, please send the above information via email to reeffarmers@rocketmail.com or use this auto MAILER.

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