Hook-Um Dano Ladder Locks 

Fax Order Form       

Complete our easy just Fax-it Order Form and fax-it to 702-565-6237. 

Please fill out form, print it, then fax it and if you choose, we will email you your total before your order is shipped.             
Check them out online at www.hookumdano.com. (you can also order thru website)

CHECK ONE
  Email Shipping and Handling charges before order is shipped.
  No need to email S|H charges, please just ship order. Be sure to enter your email and phone number. Thank You!
PRODUCT ID

  QTY

             ITEM PRICE 

TOTAL PRICE

Ladder Lock    

$29.99 ea.

$

1 Case (dozen)

 $359.88 ea.

$

SHIPPING & HANDLING

$

We Accept

Visa/MasterCard

  TOTAL

$

BILLING INFORMATION SHIPPING INFORMATION (Check if same as billing)
Name 
Company 
Address 
City 
State Zip
Phone
Email
Name 
Company 
Address 
City 
State Zip
Phone
Email
Credit Card Information
Credit Card Type

(Check One)  Master Card Visa

Name On Credit Card

Credit Card Number

Expiration Date


Or  mail this form with Check To:
Ventura|Deeter International | 35 E. Horizon Ridge Pkwy. #110 – 233 | Henderson, NV. 89015 | eMail: sales@hookumdano.com

Copyright © 1999-2009 Ventura/Deeter International | Lasted updated on 11-27-09