Hinge Order Form

Print out and complete the form below. Please make check payable to QM Replacements (the factory is not set up to accept credit cards) and mail to:

QM REPLACEMENTS
96 COMMERCE DR #181
READING, PA 19610

 

Name
Address
City
 State Zip
Phone
  

 

Hinge
Number
Quantity
Price per Pair
(see hinge selection page)
Subtotal
Shipping &
Handling*
Grand Total
*Shipping and handling - for orders under $50, add $6; for orders $50 and over $10

Thank You