PRINTABLE ORDER FORM: **Enclose this form with your firearm when you send it to us for work.   M & R Specialties 1126 S. Gratiot Ave. Mt. Clemens, MI 48043 (586) 954-3998 Date: ___________________ Customer Name: ___________________________________________ Street Address: _____________________________________________ City: _____________________________ State: ___________________ Zip Code: ____________________ E-Mail Address ___________________________________ Daytime Phone: Area Code _________ Phone:_______________ Firearm Manufacturer: _____________________________________ Serial#________________________ Caliber:_________________ Model: __________________________ Finish Desired :________________________________________________ ( ) Rings & Bases ( ) Muzzle Brake ( ) Extra Mags ____________ Special Instructions:____________________________________ Payment Type: ( ) Money Order/Cashiers Check Enclosed ( ) Visa ( ) MasterCard Card Number: ___________________________ Exp.:_______________ Name on card:_______________________________________________ Signature: ___________________________________________________     To learn more about how you can protect your private, police, or military firearms with Diamondkote, please contact us either by mail, phone, or e-mail:   M & R Arms Specialties 1126 S. Gratiot Ave. Mt. Clemens, MI 48043 (586) 954-3998 service@mrarms.com Look at a Map >>   Copyright © M & R Arms Specialties 2000-2003. All Rights Reserved.         Website maintained by Advantage Information Systems