Automated Order Form

Cord King, Inc.
P.O. Box 233
Scandia, MN 55073
Phone or Fax: (612) 433-3550

This is an automated order form, please fill in all of the following information.
When you are finished, print the form and mail it to us with your check or money order.
You can expect to see your order within 2 weeks.

Thank you!

Name
Address
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Zip Code
Country
Telephone
E-mail

Ship to

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	Product	Quantity	Price ea.	Line total
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	Subtotal
	(Minnesota residents must pay 6.5% sales tax) Sales Tax
	Shipping & Handling			No Charge
			Order Total