Online Parts Order Form

Complete the form below to forward a parts order to our Parts Department.  We are unable to accept credit card orders online at this time.  You may also call the Parts Department by telephone at (740) 927-3464, print online form and fax to (740) 927-7110 or  click here to send an E-Mail inquiry.

Name:    

Title:      

Organization:    

Street Address:    

City:    

State/Province:    

Zip/Postal Code:    

Country:    

Telephone Number:    

Fax Number:    

SMI Model Name:    

SMI Serial Number:    


Please provide the following order information:

Purchase Order Number:    

Preferred Shipping Method:       Next Day       Ground


SHIPPING ADDRESS  (If different From Above)


Street Address:    

City:    

State/Province:    

Zip/Postal Code:    

Country:    


COMMENTS:





By completing this form and clicking "Submit", you are authorizing Screen Machine Industries, Inc. to
place/ship a parts order for your firm.  After clicking submit, your order cannot be changed unless you
call the factory and speak with a parts representative.  You will receive an immediate form confirmation after submitting your order.  If you do not see the confirmation screen, your order has not been placed.