Print the following form out on your printer and either mail or fax to us at the address listed below.
Order Form NAME: ____________________________________________________________ ADDRESS: _________________________________________________________ ___________________________________________________________________ SHIP TO: __________________________________________________________ ___________________________________________________________________ PHONE: ___________________________________________________________
ITEM 1: MANUFACTURER: __________________________________________________ STYLE: ____________________________________________________________ COLOR: ___________________________________________________________ SIZE: ______________________________________________________________ SQ. YDS: _____________ PRICE: _____________ TOTAL: _____________
ITEM 2: MANUFACTURER: __________________________________________________ STYLE: ____________________________________________________________ COLOR: ___________________________________________________________ SIZE: ______________________________________________________________ SQ. YDS: _____________ PRICE: _____________ TOTAL: _____________
ITEM 3: MANUFACTURER: __________________________________________________ STYLE: ____________________________________________________________ COLOR: ___________________________________________________________ SIZE: ______________________________________________________________ SQ. YDS: _____________ PRICE: _____________ TOTAL: _____________
PADDING: TYPE: ________________________ SQ. YDS: __________________________ PRICE: _______________________ TOTAL: ___________________________
SUBTOTAL: ____________________ SALES TAX: ____________________ (No GA Sales Tax when Shipped Out of State) TOTAL: ________________________ I am paying by: Check Enclosed Credit Card #: __________________________________ Exp. Date: ____________ Cardholder's Name: ___________________________________________________ Cardholder's Signature: ________________________________________________ Mail form to: Or fax information to: (706)226-2483 www.qualitydiscountcarpets.com email: sales@qualitydiscountcarpets.com
Order will be processed upon receipt of funds when accompanied by check. |