Hardware and  supplies order  form
Shenandoah Antique Restoration
559 SW Belmont Ave
Lawton, OK  73501


Hardware and Restoration Supplies
1-800-575-1960     
     580-951-0234
info@shenandoahrestoration.com
Customer Info:
Name__________________________
Address________________________
Address________________________
City___________________________
State, Zipcode___________________ Phone
Number__________________
Email address___________________
Please Print
Date of order:
__/__/____
Qty
Part Number
Description
Units
Price
Total
           
           
           
           
           
           
           
           
           
           
           
           
        Shipping
 
        Order
Total
 
Ship  to Address   Same as above___

Name__________________________
Address________________________
Address________________________
City___________________________
State, Zipcode___________________
Shipping Cost:                        Add
Orders totaling up to $14.99  - $5.95
$15.00 - $29.99                     - $9.70
$30.00 - $49.99                     - $11.25
$50.00 - $99.99                     - $13.50
$100- up                                - $18.75
Payment Type:
Check___
Money order___
Credit card___   ( see below)
Print this Order Form and mail to  the
above  address.

Or  
copy and paste to your email and
email your order in to us.

Thanks for your order!
Shenandoah  Antique Restoration
Credit Card Orders:
Visa____   Master Card____Amex____ Disc____
Card Number:_________________________
Expiration Date:_______________________
CV number on back of card_____________
Name on card:________________________
Billing Address:________________________
____________________________________
____________________________________
____________________________________
Phone Number:________________________
Shenandoah Antique Restoration
Antique  Restoration Hardware