Manual Order Form

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

This is the manual order form. If you would like to use our automated order form,
and your browser supports Java, please click here.

Please print this form and fill in all of the requested information.
When you are finished, mail it to us with your check
You can expect to see your order within 2 weeks. If after 2 weeks you have not yet received
your order, please call us at the number shown above.

Thank you!

Name
Address
City
State/Province
Zip Code
Country
Phone Number
E-Mail

Ship to

City
State/Province
Zip Code
Country


	Product	Quantity	Price ea.	Line total
1.
2.
3.
4.
5.

	Subtotal
	(Minnesota residents must pay 6.5% sales tax) Sales Tax
	Shipping & Handling			No Charge
			Order Total