Evald Moulding™                        ORDER FORM                                  

BILL TO:                                                                    SHIP TO:   (if different than billing address)
Name:               Name:     
Address:            Address: 
City:                             City:         
State:           Zip:        State:          Zip: 

Acct Number:          
Person Placing Order:  
Contact Phone No:     --                           

Type of Account:   Charge Card COD Open Account
Ship Type:   Delivery Pick-Up Speedee UPS

Qty:      Item No:       Size:    Type:  Chop Insert Join Join Length Ready Made
Qty:      Item No:       Size:    Type:  Chop Insert Join Join Length Ready Made
Qty:      Item No:       Size:    Type:  Chop Insert Join Join Length Ready Made
Qty:      Item No:       Size:    Type:  Chop Insert Join Join Length Ready Made
Qty:      Item No:       Size:    Type:  Chop Insert Join Join Length Ready Made
Qty:      Item No:       Size:    Type:  Chop Insert Join Join Length Ready Made
Qty:      Item No:       Size:    Type:  Chop Insert Join Join Length Ready Made
Qty:      Item No:       Size:    Type:  Chop Insert Join Join Length Ready Made
Qty:      Item No:       Size:    Type:  Chop Insert Join Join Length Ready Made
Qty:      Item No:       Size:    Type:  Chop Insert Join Join Length Ready Made
Qty:      Item No:       Size:    Type:  Chop Insert Join Join Length Ready Made

Special Instructions (ex. allowances, cutting instructions, etc):

Orders placed after 2:00 p.m. central standard time will be considered part of the following days work.