For Online Ordering Click Here!!!

       

     

 

Special Event Order Form

We need as much information as you can give us for better delivery and invoicing.

(To move between fields, please use the tab key.  Hitting the enter key will complete your order)
Person Requesting
Company Name (if applicable)
Billing Address
City, State & Zip Code
E-mail Address
Home or Work Telephone Number
Mobile Number
Start date of Event
Ending date of Event (If same day as Start date, please list that date here also)
Type of Event 
Method of Payment (If COD, someone must meet driver at delivery on site for payment or payment must be received in our office one week before unit is to be delivered)
If Method of Payment is Credit Card, Please enter the card number and expiration date to the right (or you can call the number in to our office) Credit Card #  (no dashes please!))

Expiration Date (mo/yr)      

 

In the drop down boxes below, please choose the type of unit you would like to order along with the number of each unit you want.  If you have any questions about what unit you would like you can either call our office or look on the Special Event web page to see all the units we offer.  Remember, for orders of six or more total units you will need to call our office toll free at 1-877-375-8988!! 
Unit Type Number of Units

 

Directions to your Event (If this section is not filled in, your unit (s) cannot be delivered!)

 

Placement of the units at your event. (This section is very important, if it is not filled out our driver will place the unit (s) at his discretion.  In order to have the units placed where you want them, you must first tell us where to put them.)

PLEASE NOTE: WE ARE LOCATED IN NORTH CAROLINA & SOUTH CAROLINA.  OUR MARKET AREA IS IN NORTH CAROLINA AND SOUTH CAROLINA.  WE DO NOT PROVIDE PORTABLE TOILETS TO OTHER STATES.  WE ALSO DO NOT SALE PORTABLE TOILETS, WE ONLY RENT THEM.  IF YOU NEED A PORTABLE TOILET OUTSIDE OF NORTH OR SOUTH CAROLINA, PLEASE CONTACT THE PORTABLE SANITATION ASSOCIATION (WWW.PSAI.ORG) AND THEY CAN GIVE YOU THE NAME OF A COMPANY TO CONTACT IN YOUR AREA.

 

 

 

 

 

 

PORTA-JON

TOLL FREE 1.877.375.8988

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Last modified: October 02, 2007
Created by Pam Russell
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