Mail and Fax In Order Form

Fill in this form and print it from your computer to send in an order, or use the shopping cart to place an order online.
To send in a check for your order, please mail this form and the check to:

The MailboxWorks
1743 Quincy Avenue, Suite 151
Naperville, IL 60540
Fax (630) 355-9619
NOTE: For payments by check, your order will be processed once your check has been received and cleared the bank.
If you wish to use a credit card to pay for your order, please fill in the appropriate fields below.
Please make sure to include all shipping charges in your total.

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

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





			Subtotal**

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

Select shipping method

Payment method:

Check enclosed

Please bill my: Visa Mastercard AMEX Discover
Card number
Expiration Date (MM/YYYY) /
Name as it appears on the card
How did you hear about us?

Additional notes on the order

Please print this form and Fax to:

Fax (630) 355-9619

or mail to the address listed at the top of this page.

NOTE: If your information is cut off on the sides of the pages when you print, set the print margins to 0.75" or less. Consult the help menu on your browser for more information on how to do this.

If you have any questions about ordering via Fax, mail, or online, please call us at 1-800-824-9985.