Required Fields are highlighted yellow
What would like to order? (UPS Orders only)
Type a Quantity in each box for the items you wish to order.
Bill to Information
Complete Information about Whom will pay for this order, and method of payment.
Name of person who is placing this order:
Title of Person placing this order (If applicable):
Phone numbers to reach person placing the order.
E-mail address for the person who is completing this form:
Your Purchase Order No. (if applicable):
Not required.
Method of payment you will use? In the box at right, please type in one of the three choices of payment:
Business Check, Personal Check, or Credit Card:
We accept only VISA and MASTERCARD credit cards.
VISA and MasterCard informationIf you are not using a credit card to make payment then proceed to "bill to information" below.
You do not have to give your credit card info through this online form. If you would rather not,
then type "call me" in the type of card box below, and we will contact you for credit card information.
Type of Credit Card (Visa or MasterCard) at right:
(Type in this box the word 'Visa' or 'MasterCard '
Name as it appears on the Credit Card:
Address the Credit Card is billing goes to:
City for Credit Card Billing:
State for Credit Card Billing:
Zip Code for Credit Card Billing:
(no spaces)
Expiration 0f Credit Card:
(Expiration Month, then year)
3 Digit security code on back of Credit Card:
(3 digit security code on back of card)
Bill to Information
If you are not using a credit card for payment, then we will mail you an invoice. Please provide
Bill To information below.
Organization or Name of Person who is paying for the order:
Person's Attn. the invoice should be mailed to:
Street Address or P.O. Box for Bill to address:
Ship to Address
If the information is all the same as the "Bill to" information above, then type "same as above"
in the first box below.
Organization or Individual's Name to Ship to:
Street Address (Cannot be a P.O. Box):
In the box at right, please tell us if the Ship to address is a "Residential" or "Business" address:
You may wish to "Print" this page before you click the submit button.
Thank you for completing our on-line form.
*Submit Note:
When you click the 'Submit Request' button you may get a message from your browser that says something similar to: "you are submitting the form via e-mail....or, submitting this form will reveal
your e-mail address.....etc.". This is an automatic message sent by some internet browsers. When you click the "submit request" button, your message will be sent to Heying Co.
If you do not get some kind of reply from us within
72 hours (usually quicker), then you should assume your message was never received at our end. In this case, please call us so we can fix the problem.