Custom Linen Service 14332 Wadkins Avenue Gardena, California 90247 Phone: (310) 675-8200 • Fax: (310) 675-7080 ORDER FORM Print and Fax or Mail your Orders

Order Date:	________________________________
Date Needed:	________________________________

Billing Information: Name: _______________________ Address: _______________________ _______________________ Phone: _______________________ Fax: _______________________ Ordered by: _______________________ Email: _______________________

Shipping Information: Name: _______________________ Address: _______________________ _______________________ Phone: _______________________ Fax: _______________________ Please check here if the shipping address is a residence:  ___

Method Of Payment

___  Prepay (check or money order enclosed) ___  Visa     ___  Mastercard Card # ___________________________   Expiration: ________ Full Name on Card: _______________________________________________________ Any Quantity Under 6 pcs.. Add A 50% Cutting Charge

Quantity	Size	Color	Fabric

Shipping Options Please specify:    ___ Ground  ___ 3 Day  ___ 2 Day AM  ___ Next Day Air  ___ Priority Mail