New Customer Contact Form

Dispersion Technology Systems LLC
d.b.a. Electro-Fast Distribution
E-Mail: Accounting@electrofast.com
Phone: 610-279-8294 x106 for A/R and x100 for Customer Service
Fax: 610-279-3917

Registered Company Name

D.B.A.

website address

Billing Contact Name

Billing Phone Number

Billing E-mail

Bill To Street Address

Bill State

Billing Zipcode+4

Ordering Phone Number

Ordering Contact Name

Ship To Street Address

Ship to State

Shipping Zipcode+4

Shipping County

Shipping Carrier

PO required

Back orders allowed

Additional Information: (tax exempt#, shipping Carrier info)

Click on the submit button to setup an email to send to DTS. Please attach a tax exemption form if tax exempt before sending email: