Instructions:
Please print this form, fill it out, and then either fax to (207)
775-7898 or mail to the address listed below. |
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Description (include color if known) |
Item # |
Size |
Price |
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Shipping: |
FREE! |
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Total: |
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Payment
Information: |
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Please check a payment method and/or fill in required
information. |
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___Visa |
___Master Card |
___Discover |
___American Express |
___Check |
___Money Order |
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| Name
On Card:________________________________________ |
| Credit
Card No:________________________________________
Exp. Date____/____ |
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Signature:____________________________________________
*Required |
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| Mail check or money orders to: |
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Downeast Rug Company
P.O. Box 309
Westbrook, ME 04098-0309 |
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Billing Information: |
| Name:_______________________________________________ |
| Street
Address:________________________________________ |
| City:
___________________________ |
State:_________________ |
Zip:
___________ |
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| Shipping
address same as billing? ____Yes ____No ( If not,
please fill in below.) |
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Shipping Information: |
| Name:_______________________________________________ |
| Street
Address:________________________________________ |
| City:
___________________________ |
State:_________________ |
Zip:
___________ |
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*Shipping
and Handling Charges: We offer FREE shipping and handling on all of
our rug orders within the
Continental United States. Shipping cost to Alaska, Hawaii, and
Canada will be added to your order.
*You will be contacted if the actual total differs. |