Mail and Fax In Order Form


The MailboxWorks 1743 Quincy Avenue, Suite 151 Naperville, IL 60540 www.mailboxworks.com	3 Ways to Submit Order Form 1. Mail this form to the address to the left 2. Fax this form to 630-355-9619 3. E-mail this form to info@mailboxworks.com

Payment Information We accept all of the major credit cards, including VISA, MasterCard, Discover and American Express. Prepayment is required for all orders. You can e-mail us or call us to get a shipping quote.

BILLING ADDRESS	SHIPPING ADDRESS Check if your billing and shipping address are the same
Name Company Street Address Street Address 2 City, State Zip , Daytime Phone - - , ext. Evening Phone - - E-mail	Name Company Street Address Street Address 2 City, State Zip , Daytime Phone - - , ext. Evening Phone - -

Qty	Item #	Description	Options (Color,size, etc.)*	Price	Total





				Subtotal
				Shipping**
				Tax***
				Total

*Additional options may also be noted in the additional notes section below.
**Call for shipping charges
***Orders within Illinois will be subject to tax.

Select shipping method:

Select Payment method:
For fastest processing please enter your credit card information. Please allow extra processing time for check payments.

Card number
Expiration Date (MM/YYYY) /
Name as it appears on the card
How did you hear about us?

Additional notes on the order

Lowest Prices on Mailboxes, Period.

Mail and Fax In Order Form