Fiberglass Mail Order Form
Please print and then fill in information and send to address below.
 
 
E-Mail   SHIP TO (IF DIFFERENT)
Name   Name  
Address   Address  
City/St/Zip   City/St/Zip  
Daytime Ph #   Daytime Ph #  
 
Screen Size
Qty
 
Description
Unit Cost
Total
84 inch width screen
 
Screen
 
 
96 inch width screen 
 
Screen
 
 
 
 
Screen
 
 
 
 
Screen
 
 
Screen roll size
# rolls
Description
 
84 inch X 100 feet
 
A roll of screen material
$ 183.95
 
96 inch X 100 feet
 
A roll of screen material
$ 203.00
 
   
Screen Attachment devices
   
&  
 
 
 
 
 
 
 
.  
   
Subtotal:
 
Shipping is $12.50 per order of cut screen or Screen attachment devices
Shipping:
 
Shipping is $ 35.00 per roll of screen
Total:
 
 
Please make check payable to Porch Screens    
 
Fiberglass Screens
55648 Silver Creek Lane
Macomb Twp, Mi 48042
FORM 103 rev Dec 03