Please fax this form to: 1-218-694-2897
Please use a black pen and print neatly to ensure a clean fax - THANKS!

Store Name:__________________________________________________________________________

Address:__________________________________________________________    

City:________________________________ State:_____________________    ZIP:________________

Phone number:___________________________________

Please use a different line for each different color ordered.

Stain abbreviations:     P - provincial or med. oak / G - golden oak / C - colonial / W - dark walnut or dark oak
                                 M - mission / N - natural or light oak