John and Heather Forms

Name *

First Name Last Name
Email *
example@example.com
Phone Number *

- Area Code Phone Number

Billing Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Ordering Process
What would you like to order? *

Coatings Flakes
Type of Flakes

Pre Made Flake Colors Manufacturer Signature Blends or unicolor Custom Flake Color

Flakes

	How many pounds of flakes?
River Rock
Saddle Tan
Khaki
Creekbed
Seal Masters
B330
Sandstone
Shoreline
Autumn
Gray Blend
Tuxedo
Stonehenge
Dorric Brown
New Dorric Brown

Type in Your Custom Color ***Additional fees may be assessed to customer colors *
How Many Pounds of Custom Color Flake *
Manufacturer Signature Blends or unicolor *

Lets Confirm Your Order
Name *

Shipping Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Is your shipping address? *
Is schedule of deliver required *
Contact Phone Number
Is a lift-gate required? *
Contact Phone Number
Last 4 of CC
ANY ADDITIONAL SPECIFICATIONS ON DELIVERY WILL RESULT IN ADDTIONAL SHIPPING/HANDLING FEES.

ALL ORDERS ARE FINAL ANY CHANGES TO ORDERS WILL RESULT IN RESTOCKING FEES AND ADDITIONAL CHARGES PER ORDER.
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