Fax: 818-981-6777 or email to
sales@1allchairs.com
Chairs and Tables Direct
Los Angeles, CA, Miami, FL
800-914-1969
Date_________
Billing Info
Name: _______________________Company:____________________________
Address:___________________________City:______________ St:___ Zip:_____
Telephone#: _____________ Fax#: ______________ Email: _____________
Shipping Info ___ Check if
same as Billing
Name: _____________________Company:____________________________
Address:___________________City:________________ St:___ Zip:_____
Telephone#: _________________ Fax#: ____________ Email: _____________
Style # and Description_______________ QTY________ PRICE_________
1.________________________________________________ _____ ______
2.________________________________________________ _____ ______
TOTAL________________________________________________________
Before we confirm this order, we will call you with the exact shipping cost.
__ Check or money order enclosed. Checks must be US bank checks.
__ Wire transfer: ABA#- 121000358 Account #- Call for Account Number
__ VISA __ MasterCard ___ American Express ____
Name as it is on card __________________________________
Card #: ___________________________________ Expire MM/YR: _________
Code Number (last three digits on back of card):________
Signature as it is on
card: ___________________________________ THANK YOU