Order Reservation Form

Overland Park @
Metcalf 103 Shopping Center
Kansas City North @
Home Products Center
10333 Metcalf
Overland Park, KS  66212
Phone:  (913) 381-1335
131 N. E. 91st. Street
Kansas City, MO  64155
Phone:  (816) 436-4545 
     Fax:  (913) 381-0839                              locks2@birch.net

Order Reservation Form Instructions:
1. Click here to Print out Form   2. Fill out Form   3. Fax Form
OR
1. Press SUBMIT at the bottom of this Form
You will be contacted by Locks & Pulls, Inc. for product, payment and delivery confirmation information in 3-5 business days!

Consumer Notes:  
Check with Locks & Pulls for finish availability on each of your selections.
20% Re-stocking charge will apply on all non-stock returns.

Today's Order Date:                                          Shipping Preference Date:
    
First Name:                                                         Last Name:
    
Street Address:                                                  City, State & ZIP
    
Daytime Phone:                                                  Evening Phone:
     
Email Address:     

Shipping Preference:
*OVERNIGHT  *GROUND (*Additional charges will apply)
CUSTOMER PICKUP

Pay Preference:
CASH  CHECK CREDIT CARD BUSINESS ACCT

Department: (Sec., Cab., Bath, Fun)             Maker/Vendor Name:
    
Model Type/Name/Description:                     Part Number:
    
Finish Type: (If applicable)                             Quantity:
    

Department: (Sec., Cab., Bath, Fun)             Maker/Vendor Name:
    
Model Type/Name/Description:                     Part Number:
    
Finish Type: (If applicable)                             Quantity:
    

Department: (Sec., Cab., Bath, Fun)             Maker/Vendor Name:
    
Model Type/Name/Description:                     Part Number:
    
Finish Type: (If applicable)                             Quantity:
    

(Use this button when more than one form is submitted)

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