Print off the form mail it with your brass, or email it to us!  

Brass Exchange 

 

Name:

Phone:                                                                                                         

Email:

 

 

Billing Address:                                                                                          

 

 

 

 

 

Shipping Address:

 

 

 

 

Estimated Pounds of Brass

 

 

Order With Exchange:

 

 

 

 

 

 

 

 

Payment Method Check ___Money Order __Credit Card___ 

 

 

For Office Use Only

 

Recorded by_____________ Actual Pounds received____________________