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Order Form

Welcome to the Tane Alarm Products Order Form

Please enter your information below. Thank You.

Required fields are marked with an asterisk (*).

Name*:

Company*:

Address 1*:

Address 2:

City*:

State*:

Zip Code*:

Country*:

Phone*:

Fax:

E-mail Address*:

Web Site Address:

P.O.#:

How to Ship:

How did you hear about us*?

How do you want us to ship order?

How would you like to pay for your order?

Send Credit Application?

Yes No

Please Enter the Items You Wish to Order.
Item#	Qty.	Desc.










Tane BRIGHT LED Light (With Free Batteries) $10? Yes No

Would you like a copy of this order sent to you? Yes No

906 Jericho Turnpike New Hyde Park, NY 11040
1-800-852-5050 * NYC: 516-328-3351 * Fax: 516-326-9125
www.tanealarm.com * E-MAIL: info@tanealarm.com

Order Form

Welcome to the Tane Alarm Products Order Form

Please Enter the Items You Wish to Order.