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Mail Form To: |
Jim Fiola - Designer Craftsman
2 East Trail Branchville, NJ 07826 Phone: 973-534-7314 | FAX: 973-948-3630 http://www.dcwoodboxes.com/ jimfiola@dcwoodboxes.com ** PLEASE PRINT CLEARLY! ** |
| Name: | |||
| Address: | |||
| City: | |||
| State: | ZIP: | ||
| Phone: | E-mail: | ||
| Item Name or Number | Wood | Price Each | Quantity | Total |
| Date of Order: | Total Due $ | |||
| Please make checks or money orders payable to: JIM FIOLA | |||
| Charge cards accepted: Visa and MasterCard | |||
| Credit Card # | Exp. Date: | ||
| Signature | |||
- [ ] Check here if you wish item to be shipped to address other than indicated above ... please write person's name and their shipping address on back of this form.
- We must include 6% sales tax for New Jersey residents
- THANK YOU FOR YOUR ORDER!
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