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The Refill Connection Standard Loose-leaf Refills Order Form

Welcome to The Refill Connection's Standard Loose-leaf Products order page. This page has been designed to be filled out, printed and then faxed to us toll-free with your complete order information. Follow the simple instructions below to order your replacement time management system today.

Please follow these instructions.
  1. If ordering loose-leaf products- follow this link to a hole-template. This template will help you choose the correct size inserts for your loose-leaf agenda. To help us confirm that you have ordered the right size, please also include a fax copy of a single page from your current agenda with the holes clearly visible- if possible.
  2. Fill out all ordering information.
  3. Select your refill products.
  4. Print out the completed form.
  5. Fax the form toll-free to our Boston location for immediate service.
  6. Fax toll-free to: 877 733-4551
  7. For more information phone toll-free 866 733-4559
  8. How to find the right size insert



The following items are all required to complete your order.
Name: please enter your name as it appears on your credit card
Email Address: please enter your email address
Phone Number: please enter your phone number with area code
Billing Address: please enter your Billing Address
Ship-to Address: please enter your ship-to address if different from Billing Address.
Credit Card Number please enter your card number
Expiration Date: please enter your credit card's expiration date- MM/YY
Credit Card Type: Please select card type MC Visa Amex

Item Number Item Description Price Quantity
White only
Subtotal
PDR536-18 Loose-leaf Planning Diary 2018 $12.00
PDR536-17 Loose-leaf Planning Diary 2017 $12.00
PAD536 Note Pads (3). $3.00
ADR536 Address Pages $5.00
13D536 13 Division A to Z Tabs $5.00

Item Number Item Description Price Quantity
White only
Subtotal
PDR646-18 6-ring Planning Diary Refill 2018 $12.50 Each
PDR646-17 6-ring Planning Diary Refill 2017 $12.50 Each
FR646 Faint Ruled Pages- 30pgs front & back $5.00 per pack
TD646 "To Do" pages- 30 pages front & back $5.00 per pack
EX646 6-ring Daily Expenses- 30 pgs. front & back $5.00 per pack
PM646 Clear plastic Ruler/Page Marker $2.50 Each
BCCH646 6-ring clear plastic business card holder- holds 3 to 6 cards back to back. $1.50 each
5D646 5 Side-tab dividers with preprinted heading stickers. $2.75 each
PAD646 Slip-in Memo Pads 3 per pack $2.75 per pack
13D646 6-ring, 13 side-tab dividers with A-Z tabs $5.00
MIT646 6-ring Monthly stick-on Index Tabs $5.00

Item Number Item Description Price Quantity
White only
Subtotal
PDR82-18 3-ring Planning Diary 2018 $13.95 each
PDR82-17 3-ring Planning Diary 2017 $13.95 each
TD82 3-ring "To Do" pages- 30 pages front & back $7.00 per pack
AD82 3-ring Address Pages- 30 pgs. front & back $7.00 per pack
EX82 3-ring Daily Expense pages- 30pgs. front & back $7.00 per pack
GP82 3-ring Graph Paper pages- 30pgs. front & back $7.00 per pack
PM82 3-ring clear plastic Ruler/Page Marker $3.00 each
PDE82 3-ring clear plastic envelope with zip-type closure $5.00 each
5D82 3-ring, 5 division side tabs with pre-printed heading stickers $3.00 per pack
13D82 3-ring, 13 division A-Z index tabs. $7.00 per pack
PAD82 Slip-in Memo Pads- 5 pads per pack $8.50 per pack
MIT82 3-ring Stick-on Monthly Index Tabs $6.00 per pack

Shipping Charges
For Domestic Standard Shipping Add $5.00 to order
For Domestic UPS Blue Label Shipping Add $12.00 to order
All Foreign Orders Add $15.00 to order
Subtotal with Shipping

Massachusetts Sales Tax
Massachusetts residents please add 5% sales tax
Total Order



Please make sure that:
  • You have filled in the account information at the top of this form.
  • You have checked your order quantities, styles and ordered the correct size.