Mingo Custom Woods order form for Jewelry Closet cabinets which are similar to a jewelry box or jewelry armoire

Mingo Custom Woods

	Jewelry-Closet^TM Cabinet
	Order Form


	Bill To:		Ship To:
	Name:		Name:
	Company:		Company:
	Address:		Address:
	City:		City:
	State: Zip:		State:Zip:

	Phone #:

	Email Address:

	Purchase Order #


	Model #	Type Of Wood and Finish	Lock Type	Qty	Unit Price	Extended Price
1st Item					$	$
2nd Item					$	$
3rd Item					$	$
4th Item					$	$
	Subtotal $
	Shipping (Lower 48 States) $
	Sales Tax Kansas Residence(6.3%) $
	Total $
	MC Visa Discover Amex
	Card #
	Expiration Date:
	V-Code#(Last 3 Digits On The Signature Line):
	Billing Address of Credit Card:
	Billing Zip Code of Credit Card:

Mingo Custom Woods

1965 W 4th Street, Colby, KS 67701, (800)320-2201, (785)462-8283 Fax