floorcloth-order

To place an order, print and complete this form and send it to the address listed along with the minimum payment. Or, if you wish, complete the information form at the bottom of this page and submit it. We will call you to discuss your order and preferred method of payment.

Thank you.

Village House Floorcloths 14 Grist Mill Road Sutton Mills, NH 03221 Phone (603) 927-4765 FAX (603) 927-4765 Order Form
Name: ______________________________________ Street: ______________________________________ City/Town: ___________________________________ State: ________________________ ZIP: __________ Telephone: ( ____ )____________________________ E-Mail: ______________________________________ FAX: ________________________________________ Method of payment: [ ] Check [ ] Money Order Minimum of 50% of total due upon ordering. Remainder due at time of shipment.		Shipping rates via UPS: Under $25.00...............add $5.00 25.01-75.00......................12.00 75.01-150.00.....................17.00 150.01-300.00....................22.00 300.01 and over..................26.00
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