Bill to / Ship to:
__Business__Residence
For fast credit approval, please be sure that the billing address on your order matches the billing address for your credit card.
We will not ship to alternate shipping addresses not on record.

Name __________________________________________
Address ________________________________________
City _______________________ State______ Zip_______
Province___________________________
Country _____________________
Phone ( _____ )__________________
FAX ( _____ )___________________

Fill out the form below and either
FAX it to 724-966-8199 or Mail it to:
Fire Safety Store
211 S. Vine Street Plaza, Suite 105
Carmichaels, PA 15320

You may also place your order by contacting our toll-free number at
877-877-7050. If you have any questions concerning your order,
please email us.
Method of Payment:
___Personal Check* ___Wire Transfers (Please call)
(Sorry no C.O.D.'s)
(*Personal checks are acceptable and products will be shipped once check clears.)
Make payable to FIRE SAFETY STORE
__ Master Card__VISA __Discover __AMEX
__Check/Money Order
Credit Card Number: ____________________________
Exp.Date________
Signature _____________________________________
Absolutely no refunds after 30 days.
$25.00 charge on each returned check.
See our Terms and Policies for RETURN POLICY
We do not tolerate credit card fraud, which is a felony. If it is determined that an attempted order is fraudulent, we will report all information to the FBI at http://www.ifccfbi.gov.