SAMPLE PACKAGE ORDER FORM
Attention International Orders: DO NOT USE THIS FORM
Please Use The Link Below To
E-Mail Us For An International Shipping Quote For Samples
[ Contact Us For More Information - Click Here ]

CONTACT INFORMATION:

Please Print Carefully
Company Name: _____________________________________________________
Your Name: _____________________________________________________
Phone: _____________________________________________________
Address _____________________________________________________
City, Sate Zip Code _____________________________________________________
E-Mail _____________________________________________________
   
SAMPLES PACKAGES ORDERED:
Cellek™ Decking - Two Colors ($29.95) ____ Check Here
Cellek™ Decking - Four Colors ($39.95) ____ Check Here
Ranch Rail Fence ($29.95) ____ Check Here
Wood Grain Ranch Rail Fence ($29.95) ____ Check Here
Wood Grain Privacy ($29.95) ____ Check Here
Cascade Privacy ($29:95) ____ Check Here
Rainier Privacy ($29:95) ____ Check Here
Simulated Stone Privacy Fence ($29:95) ____ Check Here
Vicksburg Privacy ($29:95) ____ Check Here
Everest Decking ($29:95) ____ Check Here
Any Two Styles ($39.95) ____ Check Here
   
PAYMENT METHOD:
Credit Card Type: _____________________________________________________
Credit Card Number _____________________________________________________
NOTE: For VISA Card orders be sure to include the three digit verification code found on the back of your card when providing your card number above.
Expiration Date _____________________________________________________
Name On Card _____________________________________________________
Check Enclosed ____ Check Here

FAX Completed Form To: (507) 206-4153
Or Mail To: A Vinyl Fence And Deck Wholesaler
2906 15th Ave. SW Rochester MN  55902

If You Have Questions Please Call:
Phone: (507) 206-4154 · 7 Days A Week (PST)