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PARTS RE-ORDER FORM
DATE:
NAME:
ADDRESS:
CITY:
REF
QTY
RPHT300-WINGBLT
RPHT300- LOCKPIN
RPTHT300- APRON
RPHT300-CORNER
RPHT300-RLEG
RPHT300-LEV
RPHT300-MOTOR
RPHT300-PANEL
RPHT-SCORER
RPHT300-XBLIND
RPHT300-XSUPP
RPHT300-HARDWA
SHIPPING AND HANDLING:
Up to $15.00 add $2.00 for S&H
Over $15.00 add $8.00 for S&H
Console add $5.00 for S&H
HT300 Table Hockey Table
STATE:
PART#
RPHT-PUSH
PHONE:
DESCRIPTION
Wing Bolt, 5/16 x 2-5/8"
Lock Bolt (Pin)
Apron Panel
Apron Corner
Right Leg
Leg Leveler
Blow Motor
Leg Panel
Scorer, Slide
Blind, Extreme
Support, Extreme
Pin Striker Pusher
Hardware Kit
PA Residents Add 6% State Sales Tax:
Shipping and Handling Charges:
Send this form along with your
check or money order payable to:
DMI SPORTS
375 Commerce Drive
Fort Washington, PA 19034
www.dmisports.com
ZIP CODE:
UNIT
PRICE
(ea.)
(ea.)
(ea.)
(ea.)
(ea.)
(ea.)
(ea.)
(ea.)
(ea.)
(ea.)
(ea.)
(ea.)
Subtotal:
TOTAL:
TOTAL
AMOUNT
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