Order Information Form

Company name
Contact name
Street address
City
State
ZIP
Phone
FAX
Email
Resale number	State
Please select the appropriate categories
Architect Restaurant/Hotel Residential Interior Designer Bar Other Furniture Dealer Hotel Institution Club
Date Required
Quantities needed
Side Chairs
Arm Chairs
Stools
Tables
Sizes
Product information desired
Manufacturer
Model number
Finish
Upholstery
Vinyl Leather C.O.M. (Customers Own Material) Width of your fabric Pattern repeats on your fabric Horizontal inches Vertical inches
Samples request
Wood finish
Vinyl color
Leather color