R & G Supply Order Form

 Keep this window open to build your order, and use the other browser window to continue shopping.

Because of the wide range of sizes and weights of our inventory, shipping and handling charges vary with each unique order. Most of our items are small and can be shipped via FedEx Ground or US postage.  Others requiring crating and freighting. For more information about shipping/handling charges for your order, please email us. When inquiring about shipping/handling charges, please provide us with a shipping address including the zip code and let us know if we are to ship to a home or a business, bearing in mind that shipping to a business will save you money!

Please let us know how we may contact you if we need to find out more about your order.

First Name:
Last name:
Phone Number:
Fax Number:
Email Address:

Next, list what you need. The part number and quantity are required, unless you are buying a special item.

Part Number and/or Description Quantity

Type of Card- (Visa, MasterCard, Discover or American Express Only)

 Your Card Number
CVC2/CVV2 code (the 3 digits on the back of your card, except American Express where it is the 4 digits on the front of the card)
Expiration Date of Card - (Example: 10/05)
Billing Address Street Number and Zip Code- (Example: 100 Main, 76543)
Finally, please provide a complete shipping address for your order. We use US Priority Mail by default for mail shipments, FedEx Ground for parcel shipments, and LTL Freight companies for larger shipments.
Name/Company (if commercial)
Street Address
More Address Info
Zip/Postal Code
Is this a residential address? If no, you must include a company name.
*Before clicking the "Submit my order" button, please review all the information you entered to be sure it is correct.
  (To order more items, please submit a new form)

Please give your order submission a moment before shutting down the browser. We want to make sure your order gets to us! If you do not receive acknowledgement of your order within 1-2 working days, please email us or call us at 1-800-284-0416.