From this page you may fill out and print a catalog order form. Simply fill out each of the fields below, print out this page on your local printer and either mail or fax the form to us!

Catalogs ordered from within the United States are $5.00
Catalogs ordered from outside of the United States are $7.75 (US)

Date:

TO:

Tri-Chem, Inc.
Phone: (973) - 751 - 9200
681 Main Street No. 24
Fax: (800) - 914 - 9695
Belleville, NJ 07109
Attention: Customer Service Department

FROM:

First Name:
Last Name:
Street:
Street:
Street:
City:	State:
Postal/Zip Code:	Country:
Internet Address:
Phone Number:

To order your catalog, either...

• Order by mail by sending a copy of this form to the address above with a check or money order for $5.00. or $7.75 International

OR

• Order by faxing the completed form to the fax number provided above with your credit card authorization for $5.00, ($7.75 International) Please provide the following: Credit card type, Name of Holder, Credit card Number and expiration date.