1121 E. El Segundo Blvd                                                            Web Sales Order Form    Rev 1.94 01-MAR-05

El Segundo, CA 90245                                Customer Bill To Code                

 (310) 322-3444    FAX: (310) 322-4515                        *               

 www.crislu.com

 TO ORDER TOLL FREE:                                                 

 PHONE: 1-800-4-CRISLU                          PO#                                                        Start Date                          

 FAX: 1-888-4-CRISLU                          *                    *                 

                                                                                                                                                     Cancel Date

                                                                                                               *                                   :

               Attn:                                                                 

 

Example Completed Line Item:                                                                                                                        

Lin#               Finish         QTY            Style No.              Size                                                     Color               

   1                 14K               2                 6809E                  E00 - NO SIZE                       CH - CHAMPANGE

Lin#               Finish           QTY            Style No.              Size                                                     Color               

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                         

                                                                                                                 

                                                                                                                                                                                                          Form Last Revised: 03/30/2010