Sandown Wireless ROHN Products Order Form

                                          P.O. Box 564, East Hampstead, NH 03826

               FAX To: 603-887-2117, Questions: Toll Free: 866-379-8437, Tel: 603-974-0725

                                      Please Print Clearly, All Required Information

           Sold To: (credit Card Billing Address)                         Ship To: (Final Destination)

Name: ________________________________________  Name: ________________________________________

Address: _______________________________________  Address: _______________________________________

City: __________________State: ____ Zip:___________  City: ___________________State: ____Zip:__________

Telephone: __________________________ Fax: _______________________ e-mail: ________________________

Check Enclosed  ____    Money Order Enclosed ____     Credit Card Order ____

Purchase Order Number: (______________)  Master Card: ___  Visa: ___  Discover: ___

Card Number: _______________________________________________________________

Exp. Date: __________________ Name On Card: __________________________________

Signature (Required if using Credit Card) ________________________________________

Returns: Full Refund Offered for 30 days if not satisfied with Supplied Products. Items must be

Returned as new, unused parts. We will make every effort to supply the correct parts for your use.

*Please Supply Exact ROHN Products LLC Part Numbers. Call for Parts ID Help.

Please Call Sales to get your Freight Quotation. Toll Free: 866-379-8437, Fax 603-887-2117

Qty-----*Part Number-----------------Description------------------------------Price Each----Item Total

____    ______________   ___________________________________  _________  ___________

____    ______________   ___________________________________  _________  ___________

____    ______________   ___________________________________  _________  ___________

____    ______________   ___________________________________  _________  ___________

____    ______________   ___________________________________  _________  ___________

(Use a separate Sheet if you have a long list of parts required)

   Sub Total Material Cost: $____________________ Shipping Charges: $___________________

                                     Order Total: __________________ U.S. Dollars

 Shipping:

Some items are UPS shippable but most require that a Trucking quotation be given. Please Contact Sales Toll Free:

866-379-8437 for a shipping quotation to your site. There is no minimum order size at Sandown Wireless and we can

arrange shipping worldwide.

Mail or Fax This Form To:

Sandown Wireless, P.O. Box 564, East Hampstead, NH 03826

Fax To: 603-887-2117

To Contact Sales, Call Toll Free: 866-379-8437

E-mail: sales@criticaltowers.com

Personal Information will not be given to anyone else for any reason. If you feel more comfortable

Calling in this order directly to Sandown Wireless Sales, please do so. Every effort is made to protect

The privacy of our customers. That is why we ask that you mail or Fax us this information. Never

give Credit Card information to unsecured Internet servers.  Tower Parts Order are Prepaid so your

Credit Card will note a charge when you place your order. Call: 866-379-8437 or Fax: 603-887-2117.

We will be happy to quote your requirements.

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