Order Information
Send this form along with payment payable to:
Khek Brothers; 903 N. Golf Cul De Sac St.; Des Plaines, IL 60016
Or print this form and fax it to: (847) 298-8374 Phone: (847) 707-9173

Shipping Information
Shipping $5.00 for Priority Mail, $15.00 for Overnight Express Mail.

Order Form

Shipping address

Billing address

Billing Information

 Payment by check/money order enclosed

 Payment by purchase order (P.O)

 C.O.D. (collect on delivery)

 Contact us for payment information

Comments / Special Instructions