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Blind Order Form

 Referred By Request Installation Date

Measure & Estimate only? Customer PO.

Bill To Company Ship to      
Called In by Address   
Phone City
State
Zip Code
Ship Via
Attention

unit

Qty

Description

Width X Height 

Mounting

Control

Location

Color

Valance

 Brackets
1

X
2

X
3

X
4

X
5

X
6

X
7

X
8

X
9

X
10

X
 

MISC. Information

Occupied Unoccupied

Keys In Office    Pickup Keys at

Lock box           Combo #   

Existing Windows Coverings 

 

Yes No

Depose Of      Leave in Unit

Special instructions  

Type Backing 

Drywall   Mullion   Concrete   Other

 
 
 

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