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Printable Order Form |
Print and mail to: |
Blind Repair, Shade Repair, String, Cord Loops, Blind and Shade Parts and a Whole Lot More...
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| Shipping Information (Required to process order *) | |
| Name
* |
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| Address
* |
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| Address
2 |
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| City,
State, Zip Code* |
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| Phone
# * |
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| Email
Address |
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| Order
Form |
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| Qty |
Stock
# |
Description |
Price |
Amount |
| Subtotal |
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| Sales Tax (Colorado Residents Only,
Multiply 0.029 X Subtotal) |
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| Shipping is 10% of Subtotal, $5.00
Minimum, $9.99 Maximum (Free Shipping on Orders Over $100) |
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| Order Total |
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| Payment Method (Circle One) and Billing Information | ||||
|---|---|---|---|---|
| Visa | Mastercard | Discover | American Express | Check / Money Order |
| Name on Card | |
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| Credit Card Number | |
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| Expiration Date |
CVC # (3 digit number on back of card on signature line) |
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Full billing address credit card statement is mailed to: |
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