Make your own free website on

RAC Marketing
Order Form

Just print out this form, complete all information and send with your money order or check payable to: Richard Stein. If you have any questions or would like your order sent COD, fill out the "Comments or COD Order Information" portions on the bottom with your question or complete order information and click "Submit".

Name ____________________________________________________

Address __________________________________________________


Phone ________________________  Date ______________________

Home Page  |  Kar Kady - Wheelchair Carrier

RAC Marketing 7910 Treehouse Ln. Ste. 1131 Dallas, TX 75231-3135

Response-O-Matic Form



Your name:

Email address:


Any comments or COD Order Information

Complete shipping information and phone number is necessary for COD orders($15.00 must be added to all COD orders)