Fax Order Form
Print this page, fill it out completely and fax to 1-847-918-9438 or mail to:
ShadeClothStore.com
632 Innsbruck Court
Libertyville, IL 60048
Please include either a check made payable to Shade Cloth Store or your credit card information.
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Sales Tax 6.5%
Illinois Res. Only |
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Shipping & Handling |
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Total |
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Keycode: ____________
Personal Information
Name: ____________________________________
Address: ____________________________________
City:____________________________________
State:__________________
Zip: __________________
Phone Number:(____________)_______________________
Email Address: ____________________________________
Payment Method (please check one)
_____ Visa
_____ MasterCard
_____ Discover
_____ Check
Expiration Date ______________
Account # __________________
How would you like to be contacted?
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