Passenger
Section OnlyFull SetCargo Area
OnlyCarpet Order Form for VANS
Please print this page, fill it out and fax it to 214-216-4001. Or mail, along with your carpet sample to: AutoStyles, Inc. P.O. Box 889 DeSoto, TX 75123. By using this form you can be sure to get the correct carpet for your vehicle. A salesperson will contact you promptly to confirm your order. Please fill out this form completely by putting a check in the appropriate boxes. Thank You.
FREE SHIPPING inside the Continental U.S. We DO NOT Export. Thank You.
Our web address www.autostyles.com
| Name |
| Street Address |
| City State Zip or Postal Code |
| Daytime Phone |
| Email Address..............................................................@................................................................... |
| Vehicle Year | Make | Model | Part Number from Web Site |
|
ACS._ _ _ _ _ _ _-Color # |
|||
| Matching Floor Mats (Circle 1) | Front Only Set of 2 $35.00 | 4 Piece Set $45.00 | No Floor Mats / Floor Mats Only |
|
Passenger
Section Only |
Full Set |
Cargo Area
Only |
|
Column
Shift |
Floor
Shift |
Automatic |
3 Speed |
4 Speed |
5 Speed |
|
With
Console |
Without
Console |
Front
Wheel Drive |
Rear Wheel
Drive |
|
Standard
Seats |
Power
Seats |
Bench
Seat |
Bucket
Seats |
|
Short
Wheel Base |
Long
Wheel Base |
Extra Long
Please Specify Wheel Base Length...................." |
Carpet Type
|
500
Loop |
600
Nylon Loop |
Cutpile |
Molded
Black Vinyl |
Color # :......................Color Name :...................................(Not Necessary if Mailing Sample)
Payment Method
|
Visa |
Master
Card |
American
Express |
Discover
Card |
Check |
Money
Order |
Name of Card Holder......................................................................................
Account Number...........................................................................Expiration Date............/........../..........
Billing Address (if different from above address)
