Print-able Order form
PRINT THIS ORDER FORM AND MAIL WITH PAYMENT INFORMATION TO:

Collins Painting & Design, LLC
7817 Honeywell Drive
Fort Wayne, IN
46825
United States
Phone #: (260) 490-5909
Toll free #: 1-877-490-5909
Fax #: (260) 497-0317
Email: colpaint@aol.com

Circle Payment Method:          Check    Money Order    VISA    MasterCard      

  Print Name:
  Address:   Email:
  City:   Credit Card Number:
  State & Zip:   Expires:
  Telephone:   Signature:_____________________

Description

Item#

Qty.

Unit$

Total$

         
         
         
         
         
         
         
         
         
         
         
         
         
 
       

Subtotal:  

   

Shipping and Handling:  

   
Indiana residents must add 0% sales tax-   
   

MAKE CHECKS PAYABLE TO: Collins Painting & Design, Llc  

Total :

 


Thank you for shopping at Collins Painting & Design, Llc.