Fish Order Form — Regenerative Land Solutions

Regenerative Land Solutions

Fish Order Information Form

Schafer (2-2-0)

Fill out the order form below to complete your order.

Name

First Name

Last Name

Business Name

Phone Number

Please put the number to be called for delivery

Email

Number of 275 Gallon Totes

Number of 55 Gallon Drums

Order Notes

small orders, large orders, or anything pertinent to your order not already mentioned in this form

Shipping Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Billing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you have a fork lift on site?

Do you have a pallet jack on site?

Do you have a loading dock?

Do you want a call prior to delivery?

note that a call adds an extra day to delivery

Do you want to pay by Check or Credit Card?

Note that all credit card purchases will be charged a 3.5% credit card fee

When would like this shipment shipped?

Please put a specific date. We will do our best to accommodate your date. That said, it is first come first serve, so please order early if you can.