KMP Order Form
(Print This Form, Fill out and mail it to us)



Name:____________________

Address:_______________________ City_________________

State/Zip__________________

Shipping Address___________________________

State/Zip__________________

Email:______________________

Item__________________ Quantity____

Item__________________ Quantity____

Item__________________ Quantity____

Total $__________



Payment type _____Check _____Money Order

Unfortunately, KMP cannot accept Credit Card payments at this time. Orders are processed upon receipt of payment, which KMP will contact customer with order and shipping information.

Mail to:
Clifton Kemp
c/o Kemp Machine Products, Inc.
P.O. Box 691
Abita Springs, La. 70420-0543

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