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ORDER FORM
ROBERTS SALES AND SERVICE
378 Boistfort Rd.
Chehalis WA 98532
(360)245-3429
Place your order then call Pacific Time
9:00 am to 5:00 PM
MONDAY THROUGH SATURDAY
CREDIT CARD PAYMENT
THIS IS A SECURED SIGHT
CHECK OUT THE LOCK ON YOUR BROWSER
 
Payment Information:
 
 
  

Your Address 

Your Name
Phone
 
Address
City,  State & Zip Code
Your: E-Mail address to keep you informed 
E-mail 

  

Shipping Address if not the same


Ship to Name 
Phone
Address 
City, State and Zip Code 
Ship to:  E-Mail address to keep them  informed 
E-mail 

 
 
INSTRUCTIONS OR COMETS
 
PAYMENT OPTIONS 
Order directly with this form. Please press the SUBMIT button when done 

FOR CARD NUMBER DO NOT SPACE OR USE - BETWEEN NUMBERS 
 USE  2222333355556666

Card Holders Name  
Card 
Card Number exp. date  
 
1. STOCK NO.  1. QUAINT.  1. PRICE $
2. STOCK NO 2. QUAINT.  2. PRICE $
3. STOCK NO  3. QUAINT.  3. PRICE $
4. STOCK NO 4. QUAINT.  4. PRICE $
5. STOCK NO. 5. QUAINT.  5. PRICE $
6. STOCK NO 6. QUAINT. . 6. PRICE $
7. STOCK NO 7. QUAINT.  7. PRICE $
 
                                             For Washington sales tax  Washington addresses only
                                           Washington Residents please add 7.6% sales tax for items shipped to
 
                           TOTAL
We will add the shipping charges to your bill.
The Shipping Address is a residence business
PRINT THIS FORM  BEFORE YOU SUMMIT FOR YOUR RECORDS
PLEASE ALLOW TWO TO FOUR WEEKS FOR DELIVERY
AFTER SUBMIT IT WILL TAKE YOU TO ROBERTS SALES AND SERVICE AT  LOCALACCESS
SHIPPING CHARGES UPS