T & J Distributors                                                                                                                          
33 Gould St. Suite#2                                                                                                                       Date Mailed___________________   
Cumberland, RI 02864                                                                                                                    
Email: sales@kwikhang.com
www.kwikhang.com


                                                               (Please print this form and complete by hand, thank you)

                                                                                Kwik-Hang Mail In Orders


        Qty--------------E-Z Curtain Rod Brackets                                                                                    $ 2.99 Amt.  $___________

       Qty.______ Set(s)5/8 in. Blk. Drapery Rod Brackets                                                                $ 9.99 Amt. $___________

        Qty.______ Set(s) 5/8 in. Sil. Drapery Rod Brackets                                                                 $ 9.99 Amt. $ __________

         Qty. ______ Set(s) 5/8 in. Ant. Brass Drapery Rod Brackets                                                  $ 9.99 Amt. $ ___________

         Qty.______ Set(s) 1 in. Blk Drapery Rod Brackets                                                                   $ 9.99 Amt. $ ___________

         Qty. ______ Set(s) 1 in. Ant. Brass Drapery Rod Brackets                                                     $ 9.99 Amt. $___________

         Qty. ______ Set(s) 1 in. Sil. Drapery Rod Brackets                                                                  $ 9.99 Amt. $___________

         Qty. _______ 1 Ea. Ant. Brass Center Sup. Bracket                                                                 $  6.99 Amt. $ ___________

         Qty. _______ 1 Ea. Sil. Center Sup. Bracket                                                                              $  6.99 Amt.  $ __________

          Qty _______ 1 Ea. Black Center Sup. Bracket                                                                          $  6.99 Amt. $ ___________

                                                                                                                                    Plus Shipping & Handling………$ 4.95


                                                                                                                                            Total Order……………..$____________


                       Payment methods: personnel checks, money order/cashier checks. Make checks payable to: T & J Distributors and please send this completed order form to above address. To send payment by credit card or paypal, log on to www.kwikhang.com  
30 day money back guarantee from time of shipping.


Your Name and Shipping Address (Please, Please, Please Print Clearly)


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Sorry, Curtain Rods Not Available With This Form