Online Order Form
RC Expedite, Inc., 3951 W. Maple Street, Springfield, MO 65802
Phone# 417-861-8927                                        Fax# 417-863-0113
Your company Information
*Company Name
*Your Name
Customer Account Number
Company Address
City, State, Zip
*Contact Phone Number
*Your e-mail address
Pick-up Information  
*Pick-up Location
*Pick-up Contact Name
 *Contact Phone#
*Pick-up Address
*Pick-up City, State, Zip
 Estimate Mileage
*Pick-up Date (ex. 9/29/06)
 *Pick-up Time (Ex. 10:00AM)
 *Estimated Weight (lbs)
*Total# of Packages
Collect
No
 Prepaid
Yes
Payment Type
Same Day Delivery?
Package types / Vehicle types / Trip Types
*Select Vehicle Type (CTL+Click for multiple choices
*Pkg types (CTL+Click for multiple choices
No
Yes
Round Trip?
Warehousing
No
Yes
 Length of storage time
(ex. 1 day, 1 week, etc)
Warehousing Required?
Start Storage Date
# of pkgs to store
End Storage Date
Delivery Information
*Delivery Contact Person
*Contact Phone#
*Deliver To: (Name of Place)
*Delivery City, State, Zip
*Delivery Address
*Desired Delivery Time
*Desired Delivery Date
Delivery Notes or Comments:
3951 W. Maple Street
Springfield, MO 65802
* Indicates a required field
Ph: 417-861-8927
Fx: 417-863-0113
Robert@RCExpedite.com
RC Expedite, Inc.
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