WPS Order Form (Samantha Kokoszka)

Form to be used for WPS Standard Shipping Orders only. Other SBUs please follow your regular eCommerce order process.

If this is a non-standard part or service related request please enter CRM Dynamics Service Request.

If applicable, customer specific pricing process must be completed ahead of submitting this form.

ATTACH COPY OF PO AND QUOTE FOR PRICING CONFIRMATION.

Your Name: *

Your Email Address: *

Location?:

District *

Order Type: *

Customer Name: *

Sold-To Number: *

Ship-To Number (if multiple ship to #'s exist):

BA Number (if multiple BA's exist):

Bill-To Number (if multiple bill-to numbers exist):

PO Number: *

Cross Dock?:

Yes

Cross Dock Ship-To Number:

Cross Dock District & Territory:

Delivery Contact: *

Use SAP Permanent Contact

New Contact

Delivery Contact: *

Phone Number: *

Will any of these items need to be rushed?: *

Yes

No

Are we charging for freight?: *

Yes

No

1. Product #: *

Quantity: *

Unit of Measure: *

Lead Time: *

Standard

Rush

Extended Delivery Date

Delivery Date: * +

Reason for Rush: *

Unloading Point:

Add Another Product?:

Yes

2. Product #: *

Quantity: *

Unit of Measure: *

Lead Time: *

Standard

Rush

Extended Delivery Date

Delivery Date: * +

Reason for Rush: *

Unloading Point:

Add Another Product?:

Yes

3. Product #: *

Quantity: *

Unit of Measure: *

Lead Time: *

Standard

Rush

Extended Delivery Date

Delivery Date: * +

Reason for Rush: *

Unloading Point:

Add Another Product?:

Yes

4. Product #: *

Quantity: *

Unit of Measure: *

Lead Time: *

Standard

Rush

Extended Delivery Date

Delivery Date: * +

Reason for Rush: *

Unloading Point:

Add Another Product?:

Yes

5. Product #: *

Quantity: *

Unit of Measure: *

Lead Time: *

Standard

Rush

Extended Delivery Date

Delivery Date: * +

Reason for Rush: *

Unloading Point:

Add Another Product?:

Yes

6. Product #: *

Quantity: *

Unit of Measure: *

Lead Time: *

Standard

Rush

Extended Delivery Date

Delivery Date: * +

Reason for Rush: *

Unloading Point:

Add Another Product?:

Yes

7. Product #: *

Quantity: *

Unit of Measure: *

Lead Time: *

Standard

Rush

Extended Delivery Date

Delivery Date: * +

Reason for Rush: *

Unloading Point:

Add Another Product?:

Yes

8. Product #: *

Quantity: *

Unit of Measure: *

Lead Time: *

Standard

Rush

Extended Delivery Date

Delivery Date: * +

Reason for Rush: *

Unloading Point:

Add Another Product?:

Yes

9. Product #: *

Quantity: *

Unit of Measure: *

Lead Time: *

Standard

Rush

Extended Delivery Date

Delivery Date: * +

Reason for Rush: *

Unloading Point:

Add Another Product?:

Yes

10. Product #: *

Quantity: *

Unit of Measure: *

Lead Time: *

Standard

Rush

Extended Delivery Date

Delivery Date: * +

Reason for Rush: *

Unloading Point:

Special Instructions: