V.C.R. Inc. Order Form: Please print, complete the ordering information and mail to belowSorry NO C.O.D.'s. Include a phone number and e-mail so we can contact you about the details and expected ship date of your order, or just give us a call to place an order.

Mail credit card info, check or money order to:
VCR banner image - contact vcrinc_2@yahoo.com

Your Name:____________________________________________________________________________________________________

Your Shipping Address: (Street address please, UPS will not ship to a P.O. Box.) _________________________________________________________________________________________________


Your Phone number:_________________________ E-Mail:______________________________________________________________


Quantity: Item # & Description: Cost each: Total
  FR- Small Folding rocker $150.00  
  LFR- Large Folding rocker $160.00  
  LARGE DUKE - Large Duke's chair $170.00  
  SMALL DUKE - Small Duke's chair $160.00  
  CFC - campaign folding chair $90.00  
  KC - knight's chair $125.00  
  LC - large chair $70.00  
  HBC - high back chair $75.00  
  LUC - lumbar chair $85.00  
  HSC - High seat chair $80.00  
  OC12" - Low back canvas chair, 12" seat $70.00  
  OC15" - High back canvas chair, 15" seat $80.00  
  OC16" - New canvas chair, tall with foot rest, 16" seat $95.00  
  WB - Water Bucket $65.00  
  MiltB - Military Bucket $75.00  
  Canteen $45.00  
  T 16" - 16x16 table $50.00  
  T 30" - 30x30 table $100.00  
  T 40" - 30x40 table $130.00  
  WB1 - Wash Basin $70.00  
  Churn_LG - Large butter churn $95.00  
  Churn_SM - Small butter churn $65.00  
  T-11 (11" Tall) Laundry Tub $120.00  
  T-14 (14" Tall) Laundry Tub $130.00  
  T-19 (19" Tall) Laundry Tub $140.00  
    Sub total    
    Tax 7% Indiana residents only    
  Please write or e-mail for a shipping quote to your area, for your order. Shipping    
  Sorry: NO C.O.D.'S allowed.      
  Credit Card number:      
  3-digit CVS# on back of card: (usually located on signature strip)      
  Expiration Date:                                    Circle Card Type: Visa    MasterCard.       
  Name on Card:      
  Signature of card holder:



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