Total Security, Inc.

7524 N. Harlem Ave.

Chicago, IL 60631

FAX TO:

773 775-7300

Fax/Mail

Order Form

QUESTIONS?

PLEASE CALL CUSTOMER SERVICE AT

773 775-7600

In case we need to contact you about your order… 

All contact information is kept strictly confidential and is only used as needed to process your order. NO REFUNDS OR RETURNS Defective Items will be exchanged only...Thanks!

VISA____MC_____AMEX____DIS_____.

NAME ON CARD:_________________________________

CREDIT CARD #_________________________________

Exp:_____/______Signature:_____________________________

3 # V CODE ON BACK OF CREDIT CARD_______      _4 # AMEX ON FRONT_________

_Name:

_Name:

_Street:

_Street:

_City:

_City:

_{State:                            Country:                   Postal/Zip Code:}

_{State:                            Country:                   Postal/Zip Code:}

_QTY

_{Product Description}

_{Unit Price}

_{Total Price}