Customer Order Form			Date: ____________________

	Complete this form to inquire on a general or custom pallet. 
	We will contact you shortly. 

Contact Information:


   Company:
		_________________________________ 


   Contact:
		_________________________________


   Address:
		_________________________________
		
		
		_________________________________


   City:
		_________________________________ 


   State:
		________________ 


   Zip:
		________________
		

   Phone:
		________________ 


   Fax:
		________________


   Email:
		____________________ 


   Where did you hear about us?_____________________________________________ 
    

General:


   Pallet Name:
		____________________________


   Overall Size:


	Length: ____________________________
	
	Width: 	____________________________


	Wing:	____________________________
	

	Top: 	____________________________

	Bottom: ____________________________


	Markings:____________________________


   Load Weight:


	Minimum: ___________________________

	Maximum: ___________________________



Stringers:
 


   Material:	____________________________


   Quantity:	____________________________


   Width:	____________________________


   Height:	____________________________



   Notched:	____________________________



Top Deckboards:


   Material:	____________________________ 


   Quantity:	____________________________ 


   Chamfered:	Yes  ____  No ____


   Thickness:	___________________ 


   Width:
	Begin from the top and specify the width 
	of each board across the pallet. 
	(typically either 4" or 6" wide)


1:_____		6:_____  
2:_____ 	7:_____ 
3:_____  	8:_____	 
4:_____ 	9:_____ 
5:_____        10:_____
  
 
  
	Evenly Spaced:	Yes ____    No ____

Bottom Boards:


   Material:	____________________________


   Quantity:	____________________________ 


   Chamfered:	Yes _____    No _____


   Thickness:	___________________________ 


   Width:
	Begin from the top and specify the width 
	of each board across the pallet. 
	(typically either 4" or 6" wide)


1:_____		6:_____  
2:_____ 	7:_____ 
3:_____  	8:_____	 
4:_____ 	9:_____ 
5:_____        10:_____
  
 
  
	Evenly Spaced:	Yes ____    No ____





Delivery Requirements:


   Delivery Type:________________________________ 


   Location:	 ________________________________


   Estimated Usage:
		pallets per month________________


   Additional 
   Comments: 
_______________________________________________________

_______________________________________________________

_______________________________________________________ 

Mail To:

P.O. Box 137 Markleville, IN 46056

Fax To:

765.533.4312