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Sample Chair Order Form
Please fill out to order your sample Worship Chair.
Sample Ordering: Chapel Stacker Fresco Cadera
Church/Org:
Your Name:
Delivery Address:
City:
State / Prov Zip / Postal Code
Contact Phone: Cell:
Email:
Comments:
Color Choice: Any Navy Blue Burgundy Hunter Green Grape Special - write in comments
Note: We often have chairs made in advance to send out as samples. These are in standard colors like navy, burgundy, etc. We can build you a sample in fabric of your choice, but we may have to wait for fabric from the mill. If you are in a hurry, select a standard color.
You can pay for this ($50.00 includes shipping) by credit card or fax us your check to 540-484-4915. This is a secure 24/7 fax line. You can also mail us a check to:
Worship Chairs PO Box 513 Rocky Mount VA 24151
Note: there is no tax unless you are in VA, and if you are a church there will be no VA tax if you sign and fax us the tax exemption form found here.
Standard fabric samples usually ship in 48 hours.
This is a secure page
I prefer to pay by : Visa MasterCard Discover Fax my check Mail my Check Fax & Mail Check
Credit Card Number:
Expiration: Month: Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Year 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Security Code This is the last 3 digit code on back
If the address where you receive your credit card bill is different from the shipping address, please enter it below.
Name on card:
Billing Address:
State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip / Postal Code:
A receipt will be emailed to you. Thank you!
Chapel Stacker
Fresco Chair
Cadera Chair
Sample Chairs
To keep our prices low we do not offer free samples. Sample chairs are available for $50.00 each (includes UPS)
ASSISTANCE
(540) 493-0540 or
1-800-383-5903
We are available Monday - Friday 9:30 AM - 5:30 PM Eastern Time
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Office: (540) 493-0540 Email
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