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PLEASE PRINT |
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| Your Name |
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| Ship to Address |
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| City & State |
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Zip Code |
| Telephone: ( ) email: | ||
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Payment Method: c Faxing Check c Mailing Check/M.O. |
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| Size | Mattress Model | Sale Price | Quantity | = Total for Item(s) |
| King (76"x80") | ||||
| Cal. King (72"x84") | ||||
| Queen (60"x80") | ||||
| Full XL (54"x80") | ||||
| Full (54"x75") | ||||
| Twin XL (39"x80) | ||||
| Twin (39"x75") | ||||
| SPECIAL THIS MONTH | FREE SHIPPING OFFER | Shipping | 0 | |
| TOTAL FOR ORDER: |
$ |
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PLEASE MAKE CHECKS PAYABLE TO AirBedDirect.com
Please print this form and fax it to or mail it along with check payment. Please email us if you have any questions.
Fax: Toll Free 1-877-875-5022
Mail to: AirBedDirect.com • Furnitureland Station • AIR BED Showroom • P.O. Box 7106 • High Point, NC 27264