Mail Order Form
ANTIQUE COUNTRY FURNITURE STORE

Hoosier Cabinet
Fill out the Order Form below, then click the "Submit" button. After your order is submitted, you will receive a return Email with a confirmation of your order. It will confirm your total cost, including shipping charges and an estimated shipping date. If you would like a shipping quote before your order is placed, complete the "Shipping Quote Form" first.

                          ORDER INFORMATION

BILLING ADDRESS
       NAME:

       ADDRESS:

       CITY/STATE/ZIP CODE:

       PHONE:
               Best Time to Call:

       EMAIL ADDRESS:


SHIPPING ADDRESS ( Not required if same as billing address)
      NAME:

      ADDRESS:

      CITY/STATE/ZIP CODE:

      PHONE:
              Best Time to Call:

      EMAIL ADDRESS:
    

ITEMS to ORDER:
                  Item No/Description/Cost



                  Item No/Description/Cost






          Click the "Submit" button to Order

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