Order Request Form

Please fill in the information below so that we can be better prepared to discuss your order/questions when we can contact you. We can then finalize your order, payment method, etc. over the phone.

*Full Name:
*Main Email Address:
*Phone Number: (e.g. 401-555-1234)
Phone Number 2: (e.g. 508-555-1234)
Fax Number: (e.g. 1-800-454-9607)
*Best Time to Contact (day): (e.g. 9am-12pm; home: 1-5pm)
*Street Address 1: (e.g. 230 Oak St.)
Street Address 2: (e.g. Suite 201, or Acme, Inc.)
*City:
*State/Zip:	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Window Size: (e.g. 42" L x 30" W)
Curtain Type:	Fishtail Swag Keeping Room Swag Jabot Swag Nancy Swag Primitive String Tailored Panels Valance Tab Curtain Shower Curtain
Finished Curtain Size (including header): (e.g. 45" L x 84" W)
Fabric Number(s): (e.g. F1120)
Fabric Amount(s) for Cut Yardage: (1/2 yard minimum)
Additional Comments: