T & J Distributors                                                         Your Email________________________
33 Gould St. Suite#2                                                     Your Ph. #________________________
Cumberland, RI 02864                                          Mailing Date     _________________________
Email: sales@kwikhang.com
www.kwikhang.com


  (Please print this form and complete by hand, thank you)

Kwik-Hang Mail In Orders


Qty.______  Set(s) E-Z Curtain Rod Brackets                                  $  2.95    Amt.    $___________
Qty.______  Set(s)5/8 in. Blk. Drapery Rod Brackets                     $ 10.95   Amt.    $___________
Qty.______  Set(s) 5/8 in. Sil.  Drapery Rod Brackets                     $ 10.95   Amt.    $  __________
Qty. ______ Set(s) 5/8 in. Ant. Brass Drapery Rod Brackets         $ 10.95   Amt.    $ ___________
Qty.______  Set(s) 1 in. Blk Drapery Rod Brackets                         $ 10.95   Amt.    $ ___________
Qty. ______ Set(s) 1 in. Ant. Brass Drapery Rod Brackes              $ 10.95   Amt.    $___________
Qty. ______ Set(s) 1 in. Sil.  Drapery Rod Brackets                        $ 10.95    Amt.   $___________
Qty. _______ 1 Ea. Ant. Brass Center  Sup. Bracket                    $   6.95    Amt.   $ ___________
Qty. _______ 1 Ea.  Sil.  Center Sup. Bracket                                $    6.95    Amt.   $ __________
Qty _______  1 Ea. Black Center Sup. Bracket                              $    6.95    Amt.   $ __________

                                                                                Plus Shipping & Handling………$ 4.95


                                                                                             Total Order……………..$____________


Payment methods: personnel checks, money order/cashier checks. Make checks payable to: T & J Distributors and please send this completed order form to above address. To send payment by credit card or paypal, log on to www.kwikhang.com     30 day money back guarantee from time of shipping.


Your Name and Shipping Address            (Please, Please, Please Print Clearly)


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