|
www.woodduflo.com
Order Form
Print a copy of this form. Fill out completely.
Mail to WoodDuflo. |
|
WoodDuflo
2555
20th Ave.
Vero Beach, FL 32960
Phone (772) 562-4018
woodduflo@hotmail.com |
|
|
|
|
|
Date: ___________ |
|
|
|
|
|
|
|
|
|
Billing Address
Name________________________________
Street________________________________
City____________________State/Province____
Zip/Postal Code_________Country________________________
Phone#_____________________________
*Note: Orders paid by check will be delayed until the check has cleared. |
|
|
|
|
|
|
|
|
|
|
Shipping Address
(if other than
billing address)
Name________________________________
Street_________________________________
City_____________________State/Province____
Zip/Postal Code_________Country________________
|
|
|
| Quantity |
Name
or Number of Item |
Wood
Type |
Left
or Right |
Price/Item |
Total Amount |
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
| |
|
|
|
|
|
| Shipping:
Priority Mail rates,
per weight |
|
| |
|
|
|
Total Enclosed |
|
|
|
|
|
Payment Option:
__ Check*
__ Money Order
__ Credit Card |
|
|
Credit Card Information: __Visa
__MasterCard
Card # _________________________ Expiration Date: _________
Cardholder signature: ______________________________________
Name as it appears on card:__________________________________ |
|
Make checks and money
orders payable to
WoodDuflo
2555
20th Ave.
Vero Beach, FL 32960 Phone:
(772) 562-4018 |
|
|
|
Special Instructions :__________________________________
_____________________________________________________
_____________________________________________________ |
|
|
|
