Please use this form to mail in or fax in your order to Factory Direct. Please fill in all the following information, including your name, address, phone number, email, along with billing and shipping information if applicable.

Office Phone: (937)-743-5855
Toll-Free: (800) 252-5223
Fax: (937)-743-5500
Email: krafts2u@aol.com
1. Enter your information:
Billing Information
Name:
Address:
City:
State:
Zip Code:
Country:
Phone:
Email:
Card Type: Visa/Mastercard | AMEX | Discover
Card Number:  
Expiration Date:  
CVV:  
Signature:  
Shipping Information
Name:
Address:
City:
State:
Zip Code:
Country:
Phone:
E-Deals Signup
   
 I don't want to miss future $avings sign me up for Factory Direct Mirrors email mailing list to receive coupons and discounts!
Email:  
2 Total your order:
# Name Quantity Price
Sub Total:   $0
6.5% tax:
Ohio Residents only		 +   
$2.50 Service Charge:
For orders under $20		 +   
S & H $8.95:
Or free w/ $150 order
(Contiguous US Only)		 +   
Grand Total:
Shipping + Total		           
3. Send it in:
To complete your order...
Fax this order sheet to:
(937) 743-5500 		Or mail this order sheet to:
Factory Direct Mirrors
315 Conover Drive
Franklin, Ohio U.S.A. 45005