1. Print this form

2. Please complete the following information:

Today's Date  
Your Name  
Company  
Address
 		  
Phone  
FAX  
Email  
Quantity/
Description of Request (include measurements)		  
Date required/
Requested Delivery (weeks)		  
   

3.  Mail or FAX this form to:

Eric Miller
Precision Fab Products, Inc.
P.O. Box 256
Versailles, OH 45380

FAX: 937-526-5683

Thank you. We will respond to your request ASAP.