COMMISSION INFORMATION
Bonnie Montgomery, 1411 Bouldercrest Cir, Watkinsville, GA 30677, 706-769-8573
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Date:_____________

Customer Name:____________________________________________

Phone # (___)_____________

Address:__________________________

_________________________________

_________________________________

Rug # of rug or rugs the customer liked:__________________________

Size required for new rug: ____wide x _____long

or: Bag # of bag the customer liked:___________________________

Colors requested:____________________________________________

Type of color samples provided: ________________________________

Delivery method:____________________________________________

__________________________________________________________

__________________________________________________________

Method of payment: Check, Money Order or Cash(in person only)
Upon receipt of this order, I will respond with price(s) & approximate delivery date.

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