King Richard Co Canvas Replacement Info Form

Canvas Replacements

Pop Up Info Order Form

(For Use With King Richard Co. Office Orders Only)

Please be sure to send receipt and billing info to King Richard Co. Inc Thank You

Fax To: 1-715-255-9332

Bill To:	Ship To:
	Name:
	Street:
	City:
PH:	State:
Fax:	Zip:
Alternate Line:	PH:
Order Name Or #
Method Of Payment - Enclosing Check - 4% Discount

ROOF LENGTH

OPEN LENGTH

ARE YOU SENDING OLD CANVAS? YES NO

Please Check One (check Product page or call)

Make & Or Model (Coleman,Starcraft,Etc. )

Manufacturer ( Vesely, Vanguard, Etc. )

Model Year Or Date Of Manufacture

VEH. ID. NO. Canvas Production NO.

Add Additional Comments in the Box Below

Print Copy Before Clicking Submit