PT Tilt Table Upholstery Order

Please review your order:

Customer Info

Name: {Name (First):21.3} {Name (Last):21.6}
Email:
Phone:

Shipping Address:
{Shipping Address (Street Address):25.1}
{Shipping Address (Address Line 2):25.2}
{Shipping Address (City):25.3}, {Shipping Address (State / Province):25.4} {Shipping Address (ZIP / Postal Code):25.5}

Payment method: {Payment method:46}

Order Info

Serial number: {Serial Number:35}

Vinyl type: {Vinyl Type:17}
Vinyl color: {Vinyl color:16}
Matching original color? {Matching original color?:55}

Table width: {Table width:20}

Order notes:
{Order notes:56}

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Terms & Conditions

By checking the box below, I agree that all information I have entered is correct. I have measured my existing table and verify that the size and color choices I have entered are correct. I understand that Hill Laboratories will custom manufacture each cushion or cover according to the specifications I have entered and that no exchanges will be accepted.

I agree

Terms & Conditions*

I agree that all information I have entered is correct. I have measured my existing table and verify that the size and color choices I have entered are correct. I understand that Hill Laboratories will custom manufacture each cushion or cover according to the specifications I have entered and that no returns or exchanges will be accepted.

I agree

Name

This field is for validation purposes and should be left unchanged.

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