Box order Form
Please print & fill out, mail with payment information to:
Box & Clock Gallery
17607 Wesley Chapel Rd.
Churubusco, IN 46723
fax form to:
260-693-9801

Name_________________________________________________

Company______________________________________________

Street________________________________________________

City_________________________State______Zip____________

Ship to:_______________________________________________

_____________________________________________________

_____________________________________________________

Box #______ Size - Reg or Large (circle one)
Wood(s)________________________________Price__________

Box #______ Size - Reg or Large (circle one)
Wood(s)________________________________Price__________

Box #______ Size - Reg or Large (circle one)
Wood(s)________________________________Price__________

Box #______ Size - Reg or Large (circle one)
Wood(s)________________________________Price__________

---..........................................Total Price ___________

1-Hinged Lid
--10"x2"x5"........$115.
2-Round Sides
--10"x2"x5"........$135.
3-S Curve
--10"x2"x5"........$110.
4-Two Lids
--10"x2"x5"........$138.
5-Sliding Lid
--10"x2"x5"........$115.
6-Wings
--10"x 2 1/2"x5"........$160.

Sizes are approximate. A 100% larger size of 12"x 3 1/2"x6" can be ordered for an additional cost of $35. Heights do not include leg length.

7-Trapezoid
--10"x2"x6"........$130.
8-Wedge
--10"x2"x6"........$135.
9-Single Drawer
--10"x2"x5"........$130.
10-w/swing outs
----10"x2"x5".......$155.
11-Tip Toes
----10"x2"x5........$160.
12-Domed Top
----10"x2"x5".......$165.
Sizes are approximate.
A 80% larger size of 12"x 2 1/2" x 6" can be ordered for an additional cost of $35. Heights do not include leg length
13-Two Drawers
----10"x2"x5".........$135.
14-Four swing outs
----6"x5"x5"...........$135.
15-Two Tier
----10"x5"x4".........$170.
16-w/swing outs
----10"x5"x4".........$185.
17-Three Tier
----10"x6"x5".........$215.
18-w/swing outs
----10"x6"x5".........$275.
Sizes are approximate.
A 40% larger size - 12"
width on 13, 15, 16 is $25 additional - 17, 18 is $40 additional cost. Heights do not include leg measurement.

Click here for a printer
friendly PDF file.

Click image below to download Acrobat Reader.

25 % of total is required with order, remaining 75% plus shipping charges is due before shipping.
I will notify you by phone or e-mail when ready to ship with exact shipping charges.
Please allow 2-3 weeks for crafting.

© Copyright 2006 Seslar Design