You are now in a secure area. Please complete the entire form. We will contact you for any questions.

You may also order by phone. Call us at: 1.802.457.1578


Item Information
Item Name:
Quantity:
Wood:
Comments / Other:
Coupon # (if any):
Contact Information
Please ensure this information is correct. We have no other method of notifying you in case of order problems.
Name:
Email:
Phone:

Billing Information
If paying by credit card, then your billing name should match the name on the credit card and your billing address should match your credit card's billing address.
First Name:
Last Name:
Street Address line 1:
Street Address line 2:
City:
State/Province (US and Canada only):   
Other (for international use only):
Postal Code:
Country:

Tax and Shipping Information
Prices are subject to 5% VT sales tax, and do not include shipping charges -- which vary by weight and destination. We will contact you with a shipping estimate before we charge your credit card.

Please ship this order to the billing address.

Or ship to:
Name:
Street Address line 1:
Street Address line 2:
City:
State/Province (US and Canada only):   
Other (for international use only):
Postal Code:
Country:


Payment Information
Method of payment

Credit Card Information
(Fill out only if paying by credit card on-line.)
(Credit Card) Type of Credit Card
(Credit Card) Credit Card Number
(Credit Card) Expiration Date

If you are paying by
Personal or Corporate Check
(by mail):

Make check payable to:
Mark Lackley, Furniture Maker
18 College Hill
Woodstock, VT 05091
Date you sent check
Check #