Order Form 

Please provide the following information:

Item#	QTY	DESCRIPTION	Price/Item	Sub Total

Order Total:
Tax (If applicable):
Total:
Date of Order:

 

Stain Colour:
Special Instructions:
Options (glass colour, fabric, etc):

 

                                                                                          

	CUSTOMER NAME & ADDRESS
Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Email
Phone #

         Thank you for your order.