Union Standard Store Order Form

Use this order form to place an order from Union Standard's Ceramic Store. Simply print out the form. Identify the pieces and amounts you wish to order. Calculate the sub-total and Total charges (including tax is applicable), fill in the shipping and billing information and fax the form to Union Standard at 704-829-7992. You may also place an order by contacting Union Standard at 888-829-9295.
Use the print button in your browser tool bar to print this form.
Minimum Order: $50.00

 

Part #

Description Qty/case 1-5 cases 6-10 cases Cases Ordered Sub-Total
             
US-1199 Large Bank - 8" x 6" h 2 5.75 / pc. 5.25 / pc.    
US-1200 Medium Bank - 5" x 4.5" 4 3.95 / pc. 3.75 / pc.    
US-1201 Small Bank - 3.75" x 3" 6 1.75 / pc. 1.45 / pc.    
US-116 Porcelain Utensil Holder 1 4.85 / pc. 4.50 / pc.    
US-400 Small Jar 6 1.50 / pc. 1.25 / pc.    
Sub-Total: $
If you are located in North Carolina, sales tax will be applied 6.5% Sales Tax $___________________

TOTAL

$________________

Order Contact and Shipping Information:

Please fill in the information below completely to assist us with expediting your order. Thank you.

Ordered By:

Name:
____________________________________________________

Company:
____________________________________________________

Street:
____________________________________________________
____________________________________________________

City/State/Zip:
____________________________________________________

Telephone:
____________________________________________________

Shipping To: (if different from Billing)

Name:
___________________________________________________

Company:
___________________________________________________

Street:
___________________________________________________
___________________________________________________

City/State/Zip:
___________________________________________________

Email:
____________________________________________________

Special Instructions: (include any order or shipping instructions not specified above)

 

Payment Information:

Check or Money Order Enclosed: _________

Credit Card : Visa MasterCard American Express

Name on Card:
_______________________________________________________________

Credit Card Number:
_______________________________________________________________ Exp Date: ______/_______

Billing Address:
________________________________________________________City: _______________________ State: _________ Zip:___________

Signature: ___________________________________________________________ Date: ____________________


Notify Union Standard of any shipping damage when product is received. Damage claims will not be accepted after 5 days from product receipt.

 

Copyright 2004, Union Standard