ORDER FORM

IF YOU ARE UNCOMfORTABLE WITH ONLINE PAYMENTS, USE THIS ORDER FORM.

Just fill it in and mail it to me with your personal check,or mony order

MAIL TO Cervone's Woods 115 Bayview Dr. Beloit, Ohio 44609

QT.

THICKNES 1/4" or 3/4"

ITTEM #

DESCRIPTION

PRICE

AMOUNT

SUB TOTAL

1/4" THICK SHIPPING COST

$0.00$0.01 TO $10.00 = $2.50$10.01 TO $20.00 = $3.25$20.01 TO $30.00 = $4.00$30.01 TO $40.00 = $4.75$40.01 TO $50.00 = $5.25

OR

3/4" THICK SHIPPING COST

$0.00$0.01 TO $10.00 = $3.50$10.01 TO $20.00 = $4.25$20.01 TO $30.00 = $5.00$30.01 TO $40.00 = $5.75

YOUR TOTAL

YOUR NAME AND ADDRESS

ANY COMENTS, OR SPECIAL INSTRUCTIONS

Web Author: Joseph Cervone Jr.