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ORDER FORM
Print this form and mail, together with check or money order, payable to QWIK ™ SEAT,to:
QWIK ™ SEAT, P.O. Box 6727, Mesa, AZ 85216-6727
Allow 4-6 weeks for delivery. Satisfaction guaranteed. Product will be shipped when check or money order has cleared.
Buyer is responsible for the shipping charge for returned items.
For ordering with credit card, go to www.qwikseat.com and use PayPal option.
___ Danny, you’ve got a winner! Ship my QWIK ™ SEAT in accordance with the following specifications:
COVERING FOR SEAT: Fabric Seat, Vinyl on sides.
COLOR OF FRAME: ____ Black
QWIKSEAT - All are Powder Coated. All are adjustable from 22 inches to 30 inches.
SPECIAL INTRODUCTORY OFFER $149.50
Add $22 shipping & Handling charge FOR EACH STOOL, all shipments by
YOU MUST INCLUDE YOUR PHONE NUMBER FOR FEDEX SHIPPING
Total amount enclosed: $________ . ______
Name:_______________________________________________ Phone number(Required for FEDEX):_______________ email: __________________
Street Address:____________________________________________________________________________
City:
U.S. Patent Number: 4,951,996