V.C.R. Inc. Order Form: Please print, complete the ordering
information and mail to below
address with your payment. Sorry NO C.O.D.'s. Include a phone number and e-mail so we can contact
you about the details and expected ship date of your order. Or just give us a
call to place your order.
Mail credit card info, check or money order to:
Your
Name:____________________________________________________________________________________________________
Your Shipping Address: (Street address please, UPS will not ship to a
P.O. Box.) _________________________________________________________________________________________________
_____________________________________________________________________________________________________________
Your Phone number:_________________________
E-Mail:______________________________________________________________
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| Quantity: |
Item # & Description: |
Cost each: |
Total |
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FR- Folding rocker |
$120.00 |
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DUKE - Duke's chair |
$180.00 |
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CFC - campaign folding chair |
$75.00 |
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KC - knight's chair |
$125.00 |
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SC - small chair |
$35.00 |
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MC - medium chair |
$40.00 |
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LC - large chair |
$55.00 |
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HBC - high back chair |
$65.00 |
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LUC - lumbar chair |
$80.00 |
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HSC - High seat chair |
$70.00 |
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OC12" - Low back canvas chair, 12"
seat |
$55.00 |
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OC15" - High back canvas chair, 15"
seat |
$65.00 |
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OC16" - New canvas chair, tall with foot rest, 16"
seat |
$85.00 |
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WB - Water Bucket |
$50.00 |
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Canteen |
$35.00 |
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T 16" - 16x16 table |
$30.00 |
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T 30" - 30x30 table |
$75.00 |
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T 40" - 30x40 table |
$90.00 |
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TL 30 - 30" table leaf |
$15.00 |
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TL 40 - 40" table leaf |
$20.00 |
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Sub total |
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Tax 6% Indiana residents only |
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Please write or e-mail for a shipping
quote to your area, for your order. |
Shipping |
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Total |
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Sorry: NO C.O.D.'S allowed. |
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Credit Card number: |
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Expiration
Date:
Circle Card Type: Visa MasterCard. |
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Name on Card: |
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Signature of card holder:
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