BayTec Containers						     FAX: 888.563.8481
4761 Hwy 146                                    SHOP ONLINE: BayTec.net
Bacliff, Tx 77518                              E-MAIL: sales@baytec.net
______________________________________________________________________________

                             FAX & MAIL ORDER FORM
                          (PLEASE PRINT AND COMPLETE)
      
SHIP TO:  ____________________________________________________  [ ] Check box
          Name                                                      if you are
          ____________________________________________________      shipping
          Address                                                   to a gift
          ____________________________________________________      recipient
          City                           State        Zip Code
          
Phone:    Day (    ) ____________  Evening (    ) ____________

BILL TO:  ____________________________________________________  [ ] Check box
          Name                                                      if same as
          ____________________________________________________      shipping
          Address*                                                  address
          ____________________________________________________  
          City*                          State*      Zip Code*  *Must be same
                                                                 as printed on
Phone:    Day (    ) ____________  Evening (    ) ____________   credit card
                                                                 statement
E-mail:   ____________________________________________________

ITEM ID     DESCRIPTION                            QTY.  PRICE EA.  TOTAL

__________  _____________________________________  ____  _________  __________

__________  _____________________________________  ____  _________  __________

__________  _____________________________________  ____  _________  __________

__________  _____________________________________  ____  _________  __________

__________  _____________________________________  ____  _________  __________
            
            Attach separate sheet for more items.         Subtotal  __________                                                       

                                       SHIPPING:  UPS Ground*	  __________
           
                                                              TOTAL __________       

PAYMENT:  [ ] Visa              [ ] MasterCard
          [ ] Discover          [ ] American Express
          [ ] PO PreApproved    [ ] Check/Money Order

Acct No:  _____________________________________________  Exp. Date:  ____/____

Signature _____________________________________________ (if using credit card)

______________________________________________________________________________

Please fax this form to 888.563.8481, or mail it to the address above. Please
* Visit BayTec.net for ordering, shipping & payment info.