KiserControls Logo Kiser Controls Co.
7045 High Grove Blvd.
Burr Ridge, IL 60527
Tel. 1-630-920-9171 Mon-Fri 7-5


  


Web Order Form (Mandatory field in red)

Company Information

Company Name
Attention
Ship-to Street Address
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Ship-to State
Ship-to Zip
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Contact Information

Contact Name
Contact Phone
Contact Fax
Contact Email

Shipping Information

Ship Method Prepay & Add Pickup Collect   Collect Number
Check appropriate
UPS Ground Next Day Next Day Early AM 3rd Day
Fed-Ex Ground Priority Overnight Standard Overnight First Overnight Fed-Ex 2-Day Express Saver

Receiver Contact Information if different from above.
Contact Name
Contact Phone

Shipping Instructions
Requested Ship Date Ship Complete Ship Partial

Payment Information

Payment Method
Do you have an existing Kiser Controls Co. Account Yes No

If no, a Kiser Controls Co Customer Service Representative will contact you with payment options
PO#
Must Have an existing account with Kiser Controls Co. Terms: Net/30

Credit Card: A Kiser Controls Co. Customer Service Representative will contact you for your credit card information

Order Details

**Descriptions not Mandatory**
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