Email Order Form


To place an order, you may:

    1. Click Here to view a PDF form that you can fill out and Fax/E-Mail to us
    2. Phone in your order by calling Toll Free 1-888-474-5839
    3. Fill out the order Form Below

Order Form


Fill out this order form to place your order!
Company Name*
Siltex Customer Number*
Contact Name*
Address*
City*
Prov/State*
Postal/Zip*
Phone*
Fax
E-mail*
Please enter Quantity and Product and we will be in touch to confirm*
Any additional Questions/Comments