FLOOR FANTASY ORDER FORM

BILLING ADDRESS
NAME:
ADDRESS:
CITY		STATE:	ZIP:
TELEPHONE: ( ) -	FAX: ( ) -	OTHER: ( ) -
E-MAIL ADDRESS:

CHECK IF SAME AS BILLING ADDRESS

SHIPPING ADDRESS
NAME:
ADDRESS:
CITY		STATE:	ZIP:
TELEPHONE: ( ) -

PRODUCT INFORMATION
PRODUCT NAME	STYLE NO.	COLOR	FINISH	QUANTITY
BAMBOO FLOOR HORIZONTAL	FF36HC-SG	Coffee	Semi-Gloss
BAMBOO FLOOR HORIZONTAL	FF36HC-M	Coffee	Matte
BAMBOO FLOOR HORIZONTAL	FF36HN-SG	Natural	Semi-Gloss
BAMBOO FLOOR HORIZONTAL	FF36HN-M	Natural	Matte
BAMBOO FLOOR VERTICAL	FF36VC-M	Coffee	Matte
BAMBOO FLOOR VERTICAL	FF36VN-M	Natural	Matte
STAIR NOSING MOLDING	AS72C-G	Coffee	Semi-Gloss
	AS72C-M	Coffee	Matte
	AS72N-G	Natural	Semi-Gloss
	AS72N-M	Natural	Matte
T-MOLDING	AT72C-G	Coffee	Semi-Gloss
	AT72C-M	Coffee	Matte
	AT72N-G	Natural	Semi-Gloss
	AT72N-M	Natural	Matte
NARROW-REDUCER MOLDING	ANR72C-G	Coffee	Semi-Gloss
	ANR72C-M	Coffee	Matte
	ANR72N-G	Natural	Semi-Gloss
	ANR72N-M	Natural	Matte
WIDER-REDUCER MOLDING	AWR72C-G	Coffee	Semi-Gloss
	AWR72C-M	Coffee	Matte
	AWR72N-G	Natural	Semi-Gloss
	AWR72N-M	Natural	Matte
WALL BASE MOLDING	AWB72C-M	Coffee	Matte
WALL BASE MOLDING	AWB72N-M	Natural	Matte
QUARTER-ROUND MOLDING	AQR72C-M	Coffee	Matte
QUARTER-ROUND MOLDING	AQR72N-M	Natural	Matte

PAYMENT METHODS
BANK / WIRE TRANSFER:
C.O.D.:
CERTIFIED CHECK:

DELIVERY OPTIONS
FREIGHT DELIVERY:
PICK UP: