Product Order Form
LEVEY WALLCOVERINGS. PHONE: 1.800.588.3990 FAX: 905.829.8292
please enter the p.0. number below:
 
Billing address
company contact
phone fax
email city
address other
postal code Province
 
shipping address
company contact
phone fax
address city
postal code Province
other instructions
* IF COLLECT, PLEASE PROVIDE SHIPPING COMPANY NAME & ACCOUNT NUMBER *
 
order information
SPECIFIER  project name
Item Name product code quantity unit PRICE/UNIT
if quoted
 
Please Print Page for your files.
thank you for choosing levey industries.