Bed Shield | Wholesale Order Form

Wholesale Order Form

Fields marked with * are required, and the form cannot be submitted without them.

Company Contact Information

*Customer History:

Contact Name (if different from you):

*Full Name:

*Company Name:

*Email Address:

*Phone Number:

Accounts Payable Information (if different from company contact information)

Your invoice will be emailed to the person below.

Full Name:

Email Address:

Purchase Order:

Tax Exempt?:

Billing Information

*Street Address:

*City:

*State:

*Zip Code:

Shipping Information (if different than billing address)

Street Address:

City:

State:

Zip Code:

Product Order Form - enter quantity to the right of the product. (you may leave blank for 0 [zero])

Mattress Encasements
Size	Depth	Item #	Length	Width	Quantity
Twin	08"-11"	T-0811	75"	38"
Twin	12"-14"	T-1214	75"	38"
Twin	15"-18"	T-1518	75"	38"
Twin XL	08"-11"	TXL-0811	80"	38"
Twin XL	12"-14"	TXL-1214	80"	38"
Twin XL	15"-18"	TXL-1518	80"	38"
Full	08"-11"	F-0811	75"	54"
Full	12"-14"	F-1214	75"	54"
Full	15"-18"	F-1518	75"	54"
Full XL	08"-11"	FXL-0811	80"	54"
Full XL	12"-14"	FXL-1214	80"	54"
Full XL	15"-18"	FXL-1518	80"	54"
Queen	08"-11"	Q-0811	80"	60"
Queen	12"-14"	Q-1214	80"	60"
Queen	15"-18"	Q-1518	80"	60"
King	08"-11"	K-0811	80"	76"
King	12"-14"	K-1214	80"	76"
King	15"-18"	K-1518	80"	76"
Cal King	08"-11"	CK-0811	84"	72"
Cal King	12"-14"	CK-1214	84"	72"
Cal King	15"-18"	CK-1518	84"	72"
Hotel King	08"-11"	HK-0811	80"	72"
Hotel King	12"-14"	HK-1214	80"	72"
Hotel King	15"-18"	HK-1518	80"	72"

Box Spring Encasements
Size	Depth	Item #	Length	Width	Quantity
Twin	06"-10"	T-BOX	75"	37"
Twin XL	06"-10"	TXL-BOX	80"	37"
Full	06"-10"	F-BOX	75"	53"
Full XL	06"-10"	FXL-BOX	80"	53"
Queen	06"-10"	Q-BOX	80"	59"
King	06"-10"	K-BOX	80"	37"
Cal King	06"-10"	CK-BOX	84"	35"
Hotel King	06"-10"	HK-BOX	80"	35"
Crib	05"-08"	C-0508	28"	52"

Pillow Encasements
Size	Depth	Item #	Length	Width	Quantity
Standard	N/A	SP-2027	27"	20"
Queen	N/A	QP-2031	31"	20"
King	N/A	KP-2037	37"	20"

Additional Information

Please enter any additional information in the box to the right.

Example: "Please deliver in the back of the building at the red door".

* For added security, type in the red characters, with no spaces, in the box to the right of them:

3

8

2

4

f

Corporate Account Order Form

Bed Bug Protection | Why Bed Shield™? | Products | Testimonials | FAQ | Policies | Affiliate Program | Policies | Outside US Orders | Contact Us
© 2008, Bed Shield.com | Bed Bug Protection, All rights reserved
Website Designed By Smartimeinc.com